Prevalence of Serum IgG Antibodies to Cystic Echinococcus Antigen among Patients in an Uzbekistan Emergency Hospital.

PubMed

Park, Se Jin; Han, Sung Sik; Anvarov, Khikmat; Khajibaev, Abdukhakim; Choi, Min-Ho; Hong, Sung-Tae

2015-12-01

Cystic echinococcosis (CE) is one of the most widespread zoonotic helminthiases, which can last an asymptomatic infection for several years. The purpose of this study was to demonstrate serum antibody prevalence of CE among asymptomatic people in Uzbekistan using ELISA. A total of 2,547 serum samples were collected, 66 from confirmed CE patients and 2,481 of patients with other diseases than CE at a hospital in Tashkent, Uzbekistan. The serum samples were screened for CE specific IgG antibodies by ELISA using cystic fluid antigen obtained from sheep. The serum antibody positive rate was 89.4% (59/66) in CE and 3.6% (89/2,481) in other disease patients. The present ELISA recognized 89.4% sensitivity and 96.4% specificity. The ELISA absorbance of positive samples was distributed 0.271-0.971 for CE and 0.273-0.887 for other disease patients. The other disease patients with high absorbance over 0.3 were 50 (2.0%) who were presumed to be active CE patients. The patients in their 40s showed the highest positive rate of 5.2% (P=0.181), and women were 4.4% while men were 3.1% positive (P=0.136). The data confirmed that there are many asymptomatic patients of CE in Tashkent. It is indicated that CE is an endemic disease of public health importance in Uzbekistan.

Surveillance of sexually transmitted infections in England and Wales.

PubMed

Hughes, G; Paine, T; Thomas, D

2001-05-01

Surveillance of sexually transmitted infections (STIs) in England and Wales has, in the past, relied principally on aggregated statistical data submitted by all genitourinary medicine clinics to the Communicable Disease Surveillance Centre, supplemented by various laboratory reporting systems. Although these systems provide comparatively robust surveillance data, they do not provide sufficient information on risk factors to target STI control and prevention programmes appropriately. Over recent years, substantial rises in STIs, the emergence of numerous outbreaks of STIs, and changes in gonococcal resistance patterns have necessitated the introduction of more sophisticated surveillance mechanisms. This article describes current STI surveillance systems in England and Wales, including new systems that have recently been introduced or are currently being developed to meet the need for enhanced STI surveillance data.

Computer Surveillance of Hospital-Acquired Infections: A 25 year Update

PubMed Central

Evans, R. Scott; Abouzelof, Rouett H.; Taylor, Caroline W.; Anderson, Vickie; Sumner, Sharon; Soutter, Sharon; Kleckner, Ruth; Lloyd, James F.

2009-01-01

Hospital-acquired infections (HAIs) are a significant cause of patient harm and increased healthcare cost. Many states have instituted mandatory hospital-wide reporting of HAIs which will increase the workload of infection preventionists and the Center for Medicare and Medicaid Services is no longer paying hospitals to treat certain HAIs. These competing priorities for increased reporting and prevention have many hospitals worried. Manual surveillance of HAIs cannot provide the speed, accuracy and consistency of computerized surveillance. Computer tools can also improve the speed and accuracy of HAI analysis and reporting. Computerized surveillance for HAIs was implemented at LDS Hospital in 1984, but that system required manual entry of data for analysis and reporting. This paper reports on the current functionality and status of the updated computer system for HAI surveillance, analysis and reporting used at LDS Hospital and the 21 other Intermountain Healthcare hospitals. PMID:20351845

Epidemiology, surveillance and control of Nipah virus infections in Malaysia.

PubMed

Chua, K B

2010-12-01

The outbreak of Nipah virus, affecting pigs and pig-farm workers, was first noted in September 1998 in the north-western part of peninsular Malaysia. By March 1999, the outbreak had spread to other pig-farming areas of the country, inclusive of the neighbouring country, Singapore. A total of 283 human cases of viral encephalitis with 109 deaths were recorded in Malaysia from 29 September 1998 to December 1999. During the outbreak period, a number of surveillances under three broad groups; Surveillance in Human Health Sector, Surveillance in Animal Health Sector, and Surveillance for the Reservoir Hosts, were carried out to determine the prevalence, risk of virus infections and transmission in human and swine populations as well as the source and reservoir hosts of Nipah virus. Surveillance data showed that the virus spread rapidly among pigs within infected farms and transmission was attributed to direct contact with infective excretions and secretions. The spread of the virus among pig farms within and between states of peninsular Malaysia was due to movement of pigs. The transmission of the virus to humans was through close contact with infected pigs. Human to human transmission was considered a rare event though the Nipah virus could be isolated from saliva, urine, nasal and pharyngeal secretions of patients. Field investigations identified fruitbats of the Pteropid species as the natural reservoir hosts of the viruses. The outbreak was effectively brought under control following the discovery of the virus and institution of correct control measures through a combined effort of multi-ministerial and multidisciplinary teams working in close co-operation and collaboration with other international agencies.

How to: Surveillance of Clostridium difficile infections.

PubMed

Krutova, M; Kinross, P; Barbut, F; Hajdu, A; Wilcox, M H; Kuijper, E J

2018-05-01

The increasing incidence of Clostridium difficile infections (CDI) in healthcare settings in Europe since 2003 has affected both patients and healthcare systems. The implementation of effective CDI surveillance is key to enable monitoring of the occurrence and spread of C. difficile in healthcare and the timely detection of outbreaks. The aim of this review is to provide a summary of key components of effective CDI surveillance and to provide some practical recommendations. We also summarize the recent and current national CDI surveillance activities, to illustrate strengths and weaknesses of CDI surveillance in Europe. For the definition of key components of CDI surveillance, we consulted the current European Society of Clinical Microbiology and Infectious Diseases (ESCMID) CDI-related guidance documents and the European Centre for Disease Prevention and Control (ECDC) protocol for CDI surveillance in acute care hospitals. To summarize the recent and current national CDI surveillance activities, we discussed international multicentre CDI surveillance studies performed in 2005-13. In 2017, we also performed a new survey of existing CDI surveillance systems in 33 European countries. Key components for CDI surveillance are appropriate case definitions of CDI, standardized CDI diagnostics, agreement on CDI case origin definition, and the presentation of CDI rates with well-defined numerators and denominators. Incorporation of microbiological data is required to provide information on prevailing PCR ribotypes and antimicrobial susceptibility to first-line CDI treatment drugs. In 2017, 20 European countries had a national CDI surveillance system and 21 countries participated in ECDC-coordinated CDI surveillance. Since 2014, the number of centres with capacity for C. difficile typing has increased to 35 reference or central laboratories in 26 European countries. Incidence rates of CDI, obtained from a standardized CDI surveillance system, can be used as an important

Five-year decreased incidence of surgical site infections following gastrectomy and prosthetic joint replacement surgery through active surveillance by the Korean Nosocomial Infection Surveillance System.

PubMed

Choi, H J; Adiyani, L; Sung, J; Choi, J Y; Kim, H B; Kim, Y K; Kwak, Y G; Yoo, H; Lee, Sang-Oh; Han, S H; Kim, S R; Kim, T H; Lee, H M; Chun, H K; Kim, J-S; Yoo, J D; Koo, H-S; Cho, E H; Lee, K W

2016-08-01

Surveillance of healthcare-associated infection has been associated with a reduction in surgical site infection (SSI). To evaluate the Korean Nosocomial Infection Surveillance System (KONIS) in order to assess its effects on SSI since it was introduced. SSI data after gastrectomy, total hip arthroplasty (THA), and total knee arthroplasty (TKA) between 2008 and 2012 were analysed. The pooled incidence of SSI was calculated for each year; the same analyses were also conducted from hospitals that had participated in KONIS for at least three consecutive years. Standardized SSI rates for each year were calculated by adjusting for SSI risk factors. SSI trends were analysed using the Cochran-Armitage test. The SSI rate following gastrectomy was 3.12% (522/16,918). There was a significant trend of decreased crude SSI rates over five years. This trend was also evident in analysis of hospitals that had participated for more than three years. The SSI rate for THA was 2.05% (157/7656), which decreased significantly from 2008 to 2012. The risk factors for SSI after THA included the National Nosocomial Infections Surveillance risk index, trauma, reoperation, and age (60-69 years). The SSI rate for TKA was 1.90% (152/7648), which also decreased significantly during a period of five years. However, the risk-adjusted analysis of SSI did not show a significant decrease for all surgical procedures. The SSI incidence of gastrectomy and prosthetic joint replacement declined over five years as a result of active surveillance by KONIS. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Gender earnings and poverty reduction: post-Communist Uzbekistan.

PubMed

Bhat, Bilal Ahmad Bhat

2011-01-01

Women get less of the material resources, social status, power and opportunities for self-actualization than men do who share their social location – be it a location based on class, race, occupation, ethnicity, religion, education, nationality, or any intersection of these factors. The process of feminization of poverty in Central Asia and Uzbekistan is intimately connected to the cultural and institutional limitations that put a ceiling on women’s involvement in economic activity. This article attempts to study and explore gender in the context of poverty reduction in Uzbekistan, the most populated state of Central Asia, to understand the ways and manner in which poverty and other forms of deprivation demand women’s participation in variety of contexts. The study is primarily an empirical one and is based on an extensive sociological investigation in the field.

Health and wealth in Uzbekistan and sub-Saharan Africa in comparative perspective.

PubMed

Hohmann, Sophie; Garenne, Michel

2010-12-01

The study investigates the magnitude of differences in child and adult mortality by wealth in Uzbekistan, a former soviet country of Central Asia, and compares it with similar indicators from sub-Saharan Africa. Data were derived from Demographic and Health Surveys. An "Absolute Wealth Index" was built from data on goods owned by households and quality of housing, and scaled from 0 to 12. Wealth was distributed evenly in Uzbekistan, with a symmetric distribution around a mean of 5.5 modern goods. In sub-Saharan Africa, on the contrary, the wealth distribution had a lower mean (2.5) and was highly skewed towards the left, revealing a high proportion of very poor people. Adult and child mortality levels were lower in Uzbekistan. Despite these major differences, the relationships between mortality indicators and the wealth index were similar in the two cases. The magnitude of mortality differentials by wealth was of the same order in both cases, with gradients ranging from 2.5 to 1 for child mortality and 1.5 to 1 for adult mortality (poorest versus richest). However, mortality levels remained lower in Uzbekistan than in sub-Saharan Africa at the same level of wealth for both children and adults. A similar relationship was found between nutritional status and wealth index in both cases. On the contrary, there were no differences by wealth in use of health services and level of education in Uzbekistan, whereas wealth gradients were steep for the same variables in sub-Saharan Africa. The study suggests that mortality differentials were primarily due to nutritional status, and not to access and use of health services or to education. The discussion focuses on health and social policies during the colonial and post-colonial period that have produced these patterns. Copyright © 2010 Elsevier B.V. All rights reserved.

Periprosthetic Infection following Primary Hip and Knee Arthroplasty: The Impact of Limiting the Postoperative Surveillance Period.

PubMed

Roth, Virginia R; Mitchell, Robyn; Vachon, Julie; Alexandre, Stéphanie; Amaratunga, Kanchana; Smith, Stephanie; Vearncombe, Mary; Davis, Ian; Mertz, Dominik; Henderson, Elizabeth; John, Michael; Johnston, Lynn; Lemieux, Camille; Pelude, Linda; Gravel, Denise

2017-02-01

BACKGROUND Hip and knee arthroplasty infections are associated with considerable healthcare costs. The merits of reducing the postoperative surveillance period from 1 year to 90 days have been debated. OBJECTIVES To report the first pan-Canadian hip and knee periprosthetic joint infection (PJI) rates and to describe the implications of a shorter (90-day) postoperative surveillance period. METHODS Prospective surveillance for infection following hip and knee arthroplasty was conducted by hospitals participating in the Canadian Nosocomial Infection Surveillance Program (CNISP) using standard surveillance definitions. RESULTS Overall hip and knee PJI rates were 1.64 and 1.52 per 100 procedures, respectively. Deep incisional and organ-space hip and knee PJI rates were 0.96 and 0.71, respectively. In total, 93% of hip PJIs and 92% of knee PJIs were identified within 90 days, with a median time to detection of 21 days. However, 11%-16% of deep incisional and organ-space infections were not detected within 90 days. This rate was reduced to 3%-4% at 180 days post procedure. Anaerobic and polymicrobial infections had the shortest median time from procedure to detection (17 and 18 days, respectively) compared with infections due to other microorganisms, including Staphylococcus aureus. CONCLUSIONS PJI rates were similar to those reported elsewhere, although differences in national surveillance systems limit direct comparisons. Our results suggest that a postoperative surveillance period of 90 days will detect the majority of PJIs; however, up to 16% of deep incisional and organ-space infections may be missed. Extending the surveillance period to 180 days could allow for a better estimate of disease burden. Infect Control Hosp Epidemiol 2017;38:147-153.

Molecular Identification of Aspergillus Species: Transplant Associated Infection Surveillance Network (TRANSNET)

USDA-ARS?s Scientific Manuscript database

A large aggregate collection of clinical isolates of aspergilli (n=218) from transplant patients with proven or probable Invasive Aspergillosis (IA) was available from the Transplant Associated Infection Surveillance Network (TRANSNET), a six-year prospective surveillance study. With the objective ...

Glacial lake inventory and lake outburst potential in Uzbekistan.

PubMed

Petrov, Maxim A; Sabitov, Timur Y; Tomashevskaya, Irina G; Glazirin, Gleb E; Chernomorets, Sergey S; Savernyuk, Elena A; Tutubalina, Olga V; Petrakov, Dmitriy A; Sokolov, Leonid S; Dokukin, Mikhail D; Mountrakis, Giorgos; Ruiz-Villanueva, Virginia; Stoffel, Markus

2017-08-15

Climate change has been shown to increase the number of mountain lakes across various mountain ranges in the World. In Central Asia, and in particular on the territory of Uzbekistan, a detailed assessment of glacier lakes and their evolution over time is, however lacking. For this reason we created the first detailed inventory of mountain lakes of Uzbekistan based on recent (2002-2014) satellite observations using WorldView-2, SPOT5, and IKONOS imagery with a spatial resolution from 2 to 10m. This record was complemented with data from field studies of the last 50years. The previous data were mostly in the form of inventories of lakes, available in Soviet archives, and primarily included localized in-situ data. The inventory of mountain lakes presented here, by contrast, includes an overview of all lakes of the territory of Uzbekistan. Lakes were considered if they were located at altitudes above 1500m and if lakes had an area exceeding 100m 2 . As in other mountain regions of the World, the ongoing increase of air temperatures has led to an increase in lake number and area. Moreover, the frequency and overall number of lake outburst events have been on the rise as well. Therefore, we also present the first outburst assessment with an updated version of well-known approaches considering local climate features and event histories. As a result, out of the 242 lakes identified on the territory of Uzbekistan, 15% are considered prone to outburst, 10% of these lakes have been assigned low outburst potential and the remainder of the lakes have an average level of outburst potential. We conclude that the distribution of lakes by elevation shows a significant influence on lake area and hazard potential. No significant differences, by contrast, exist between the distribution of lake area, outburst potential, and lake location with respect to glaciers by regions. Copyright © 2017 Elsevier B.V. All rights reserved.

Monitoring Of Landslide Hazard In Selected Areas Of Uzbekistan

NASA Astrophysics Data System (ADS)

Lazecky, Milan; Balaha, Pavel; Khasankhanova, Gulchekhra; Minchenko, Venscelas

2013-12-01

Republic of Uzbekistan is situated in the heart of Central Asia. Dangerous phenomena such as drought, flooding, mud flows, landslides and others, that are becoming frequent in conditions of climate changes, increase instability of an agricultural production, and threaten rural livelihoods. In connection with weather and climate natural disasters, these phenomena become reasons of declining food production, water contamination, and economical damages. Within the Project granted by NATO: Science for Peace and Security programme, modern advanced remote sensing technologies will be applied to perform large scale monitoring of (early) slope deformations, including Satellite SAR Interferometry (InSAR) techniques, Ground Laser Scanning for in-situ refinement of detected movements or Multibeam Echosounding for monitoring slope deformation advancement into water objects. First results involving InSAR processing of selected sites in Uzbekistan are presented within this contribution.

Organochlorine pesticides residue in lakes of Khorezm, Uzbekistan

USGS Publications Warehouse

Rosen, Michael R.; Nishonov, Bakhriddin; Fayzieva, Dilorom; Saito, L.; Lamers, J.

2009-01-01

The Khorezm province in northwest Uzbekistan is a productive agricultural area within the Aral Sea Basin that produces cotton, rice and wheat. Various organochlorine pesticides were widely used for cotton production before Uzbekistan's independence in 1991. In Khorezm, small lakes have formed in natural depressions that receive inputs mostly from agricultural runoff. Samples from lake waters and sediments, as well as water from the Amu Darya River (which is the source of most of the lake water) have been analyzed to study variations in the concentrations of organochlorine pesticides residues during the year. Low concentrations of DDT, DDD, DDE, a-HCH and y-HCH compounds were found in water and sediment samples. The concentration of persistent organochlorine pesticides (DDT and HCH) in water and sediment is much lower than the maximum permissible concentrations that exist for water and soil. According to these preliminary results, the investigated lakes in Khorezm appear to be suitable for recreation or for aquaculture.

Global Emerging Infection Surveillance and Response (GEIS)- Avian Influenza Pandemic Influenza (AI/PI) Program

DTIC Science & Technology

2008-10-01

the fact that acute respiratory infections are one of the leading causes of morbidity. This capability now exists in Kenya with the first site brought...AD_________________ Award Number: W81XWH-07-2-0082 TITLE: Global Emerging Infection Surveillance and Response (GEIS)- Avian...TYPE Annual 3. DATES COVERED 13 Sep 07 – 12 Sep 08 4. TITLE AND SUBTITLE Global Emerging Infection Surveillance and Response (GEIS)- Avian

Changing panorama for surveillance of device-associated healthcare infections: Challenges faced in implementation of current guidelines.

PubMed

Gupta, Renu; Sharma, Sangeeta; Saxena, Sonal

2018-01-01

Healthcare-associated infections (HAI) are preventable in up to 30% of patients with evidence-based infection prevention and control (IPC) activities. IPC activities require effective surveillance to generate data for the HAI rates, defining priority areas, identifying processes amenable for improvement and institute interventions to improve patient's safety. However, uniform, accurate and standardised surveillance methodology using objective definitions can only generate meaningful data for effective execution of IPC activities. The highly exhaustive, complex and ever-evolving infection surveillance methodology pose a challenge for effective data capture, analysis and interpretation by ground level personnel. The present review addresses the gaps in knowledge and day-to-day challenges in surveillance faced by infection control team for effective implementation of IPC activities.

Postdischarge surveillance for infection following cesarean section: A prospective cohort study comparing methodologies.

PubMed

Halwani, Muhammad A; Turnbull, Alison E; Harris, Meredith; Witter, Frank; Perl, Trish M

2016-04-01

To assess how enhanced postdischarge telephone follow-up calls would improve case finding for surgical site infection (SSI) surveillance after cesarean section. We conducted a prospective cohort study of all patients who delivered by cesarean section between April 22 and August 22, 2010. In addition to our routine surveillance, using clinical databases and electronic patient records, we also made follow-up calls to the patients at 7, 14, and 30 days postoperation. A standard questionnaire with questions about symptoms of SSI, health-seeking behaviors, and treatment received was administered. Descriptive statistics and univariate analysis were performed to assess the effect of the enhanced surveillance. One hundred ninety-three patients underwent cesarean section during this study period. Standard surveillance identified 14 infections with telephone follow-ups identifying an additional 5 infections. Using the call as a gold standard, the sensitivity of the standard methodology to capture SSI was 73.3%. The duration of the calls ranged from 1 to 5 minutes and were well received by the patients. Results suggest that follow-up telephone calls to patients following cesarean section identifies 26.3% of the total SSIs. Enhanced surveillance can provide more informed data to enhance performance and avoid underestimation of rates. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Structure, Process, and Outcome Quality of Surgical Site Infection Surveillance in Switzerland.

PubMed

Kuster, Stefan P; Eisenring, Marie-Christine; Sax, Hugo; Troillet, Nicolas

2017-10-01

OBJECTIVE To assess the structure and quality of surveillance activities and to validate outcome detection in the Swiss national surgical site infection (SSI) surveillance program. DESIGN Countrywide survey of SSI surveillance quality. SETTING 147 hospitals or hospital units with surgical activities in Switzerland. METHODS Site visits were conducted with on-site structured interviews and review of a random sample of 15 patient records per hospital: 10 from the entire data set and 5 from a subset of patients with originally reported infection. Process and structure were rated in 9 domains with a weighted overall validation score, and sensitivity, specificity, positive predictive value, and negative predictive value were calculated for the identification of SSI. RESULTS Of 50 possible points, the median validation score was 35.5 (range, 16.25-48.5). Public hospitals (P<.001), hospitals in the Italian-speaking region of Switzerland (P=.021), and hospitals with longer participation in the surveillance (P=.018) had higher scores than others. Domains that contributed most to lower scores were quality of chart review and quality of data extraction. Of 49 infections, 15 (30.6%) had been overlooked in a random sample of 1,110 patient records, accounting for a sensitivity of 69.4% (95% confidence interval [CI], 54.6%-81.7%), a specificity of 99.9% (95% CI, 99.5%-100%), a positive predictive value of 97.1% (95% CI, 85.1%-99.9%), and a negative predictive value of 98.6% (95% CI, 97.7%-99.2%). CONCLUSIONS Irrespective of a well-defined surveillance methodology, there is a wide variation of SSI surveillance quality. The quality of chart review and the accuracy of data collection are the main areas for improvement. Infect Control Hosp Epidemiol 2017;38:1172-1181.

Impact of electronic healthcare-associated infection surveillance software on infection prevention resources: a systematic review of the literature.

PubMed

Russo, P L; Shaban, R Z; Macbeth, D; Carter, A; Mitchell, B G

2018-05-01

Surveillance of healthcare-associated infections is fundamental for infection prevention. The methods and practices for surveillance have evolved as technology becomes more advanced. The availability of electronic surveillance software (ESS) has increased, and yet adoption of ESS is slow. It is argued that ESS delivers savings through automation, particularly in terms of human resourcing and infection prevention (IP) staff time. To describe the findings of a systematic review on the impact of ESS on IP resources. A systematic search was conducted of electronic databases Medline and the Cumulative Index to Nursing and Allied Health Literature published between January 1 st , 2006 and December 31 st , 2016 with analysis using the Newcastle-Ottawa Scale. In all, 2832 articles were reviewed, of which 16 studies met the inclusion criteria. IP resources were identified as time undertaken on surveillance. A reduction in IP staff time to undertake surveillance was demonstrated in 13 studies. The reduction proportion ranged from 12.5% to 98.4% (mean: 73.9%). The remaining three did not allow for any estimation of the effect in terms of IP staff time. None of the studies demonstrated an increase in IP staff time. The results of this review demonstrate that adopting ESS yields considerable dividends in IP staff time relating to data collection and case ascertainment while maintaining high levels of sensitivity and specificity. This has the potential to enable reinvestment into other components of IP to maximize efficient use of scarce IP resources. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Epidemiology of healthcare associated infections in Germany: Nearly 20 years of surveillance.

PubMed

Schröder, C; Schwab, F; Behnke, M; Breier, A-C; Maechler, F; Piening, B; Dettenkofer, M; Geffers, C; Gastmeier, P

2015-10-01

To describe the epidemiology of healthcare-associated infections (HAI) in hospitals participating in the German national nosocomial infections surveillance system (KISS). The epidemiology of HAI was described for the surveillance components for intensive care units (ITS-KISS), non-ICUs (STATIONS-KISS), very low birth weight infants (NEO-KISS) and surgical site infections (OP-KISS) in the period from 2006 to 2013. In addition, risk factor analyses were performed for the most important infections of ICU-KISS, NEO-KISS and OP-KISS. Data from a total of 3,454,778 ICU patients from 913 ICUs, 618,816 non-ICU patients from 142 non-ICU wards, 53,676 VLBW from 241 neonatal intensive care units (NICU) and 1,005,064 surgical patients from operative departments from 550 hospitals were used for analysis. Compared with baseline data, a significant reduction of primary bloodstream infections (PBSI) and lower respiratory tract infections (LRTI) was observed in ICUs with the maximum effect in year 5 (or longer participation) (incidence rate ratio 0.60 (CI95 0.50-0.72) and 0.61 (CI95 0.52-0.71) respectively). A significant reduction of PBSI and LRTI was also observed in NEO-KISS when comparing the baseline situation with the 5th year of participation (hazard ratio 0.70 (CI95 0.64-0.76) and 0.43 (CI95 0.35-0.52)). The effect was smaller in operative departments after the introduction of OP-KISS (OR 0.80; CI95 0.64-1.02 in year 5 or later for all procedure types combined). Due to the large database, it has not only been possible to confirm well-known risk factors for HAI, but also to identify some new interesting risk factors like seasonal and volume effects. Participating in a national surveillance system and using surveillance data for internal quality management leads to substantial reduction of HAI. In addition, a surveillance system can identify otherwise not recognized risk factors which should - if possible - be considered for infection control management and for risk

Vibrio infections and surveillance in Maryland, 2002-2008.

PubMed

Jones, Erin H; Feldman, Katherine A; Palmer, Amanda; Butler, Erin; Blythe, David; Mitchell, Clifford S

2013-01-01

Vibrio is a naturally occurring waterborne pathogen with potential occupational, recreational, and commercial impacts. During the last 15 years in the U.S. and in Maryland, the incidence of vibriosis has increased. Due to the increase in cases in Maryland, warming water temperatures, and public concern about human health effects resulting from exposure to the Chesapeake Bay, we reviewed cases of vibriosis and evaluated the Vibrio surveillance system in Maryland for timeliness and data quality, attributes necessary for successful outbreak investigation and illness prevention. The evaluation included (1) informal qualitative surveys of state and local personnel who report and manage Vibrio cases and (2) a review of Vibrio surveillance data from 2002 through 2008 for data quality and timeliness of the system. From 2002 to 2008, 188 laboratory-confirmed cases of vibriosis were reported in Maryland with an annual average of 27 cases. The species of Vibrio that were most frequently responsible for infection, regardless of clinical presentation, were V. parahaemolyticus (43.6%), V. vulnificus (23.9%), V. alginolyticus (9.6%), and non-toxigenic V. cholerae (9.0%). The case fatality rate fluctuated during the study period, but the number of cases increased. The surveillance system in Maryland is flexible and captures cases of vibriosis where specimens were collected for testing; however, the system may not adequately capture mild, self-limiting infections. Better integration of data collection for clinical, laboratory, and environmental information and improved completion of variables for shellfish harvest or water exposure locations could improve the system. Quarterly meetings comprising surveillance, public health laboratory, and food-control personnel could direct and ensure the success of improvement efforts.

[Surgical site infections after cesarean section: results of a five-year prospective surveillance].

PubMed

Barbut, F; Carbonne, B; Truchot, F; Spielvogel, C; Jannet, D; Goderel, I; Lejeune, V; Milliez, J

2004-10-01

To determine the incidence of surgical site infections and to identify risk factors for infections. A prospective study of surgical site infections (SSI) after cesarean section was carried out from September 1997 to September 1998 (pilot study) and from January 2000 to August 2003, using the methodology of the American National Nosocomial Infection Surveillance System. Follow up of women was performed by midwives until discharge and during the post-natal visit. Suspected surgical site infections were confirmed by surgeons and infection control practitioners. The microbiological file of each patient was edited 30 days after cesarean section. Risk factors were analyzed using a logistic regression model. During the pilot study, infection rate was estimated at 3.2%. At multivariate analysis, factors independently associated with an increased risk of SSI were ASA score > 1, performance of cesarean section in a room not dedicated to this activity, and use of an open urine drainage system. During the following years (2000-2003), infection rates progressively decreased to reach 1.9% in 2003. Infections included superficial wound infections (involving skin and subcutaneous tissue) (47%), deep wound infections (involving deep and soft tissue (fascia and muscle) (20%) and organ/space infections (i.e. endometritis, pelvic abscess) (33%). Infections occurred after patient discharge in 47.5% of cases and diagnosis was based only on clinical findings in 30% of cases. Infected patients were hospitalized longer (median: 6 days) than non infected patients. Prospective surveillance of SSI led to better awareness of infectious problems among health care workers, to identification of risk factors and evaluation of health procedures. Surveillance contributed to a decrease in nosocomial infections.

Impact of a surgical site infection (SSI) surveillance program in orthopedics and traumatology.

PubMed

Mabit, C; Marcheix, P S; Mounier, M; Dijoux, P; Pestourie, N; Bonnevialle, P; Bonnomet, F

2012-10-01

Surveillance of surgical site infections (SSI) is a priority. One of the fundamental principles for the surveillance of SSI is based on receiving effective field feedback (retro-information). The aim of this study was to report the results of a program of SSI surveillance and validate the hypothesis that there is a correlation between creating a SSI surveillance program and a reduction in SSI. The protocol was based on the weekly collection of surveillance data obtained directly from the different information systems in different departments. A delay of 3 months was established before extraction and analysis of data and information from the surgical teams. The NNIS index (National Nosocomial Infections Surveillance System) developed by the American surveillance system and the reduction of length of hospital stay index Journées d'hospitalisation évitées (JHE). Since the end of 2009, 7156 surgical procedures were evaluated (rate of inclusion 97.3%), and 84 SSI were registered with a significant decrease over time from 1.86% to 0.66%. A total of 418 days of hospitalization have been saved since the beginning of the surveillance system. Our surveillance system has three strong points: follow-up is continuous, specifically adapted to orthopedic traumatology and nearly exhaustive. The extraction of data directly from hospital information systems effectively improves the collection of data on surgical procedures. The implementation of a SSI surveillance protocol reduces SSI. Level III. Prospective study. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

The Effectiveness of Counterterrorist Policies in Uzbekistan

DTIC Science & Technology

2012-12-01

ABBREVIATIONS AI – Amnesty International APK – Adalet ve Kalkınma Partisi (Justice and Development Party of Turkey) CIA – Central Intelligence Agency...Using StockMarket Data,” The Journal of Economic Perspectives 20, No. 2 (2006): 193–206; Ceasefires, unemployment rates, and price indexes in...Uzbekistan as well. The worsening economic conditions, high rates of unemployment , large and growing numbers of young males, repressive and corrupt

Development of a Surgical Infection Surveillance Program at a Tertiary Hospital in Ethiopia: Lessons Learned from Two Surveillance Strategies.

PubMed

Forrester, Jared A; Koritsanszky, Luca; Parsons, Benjamin D; Hailu, Menbere; Amenu, Demisew; Alemu, Seifu; Jiru, Fekadu; Weiser, Thomas G

2018-01-01

Surgical site infections (SSIs) are a leading cause of post-operative morbidity and mortality. We developed Clean Cut, a surgical infection prevention program, with two goals: (1) Increase adherence to evidence-based peri-operative infection prevention standards and (2) establish sustainable surgical infection surveillance. Here we describe our infection surveillance strategy. Clean Cut was piloted and evaluated at a 523 bed tertiary hospital in Ethiopia. Infection prevention standards included: (1) Hand and surgical site decontamination; (2) integrity of gowns, drapes, and gloves; (3) instrument sterility; (4) prophylactic antibiotic administration; (5) surgical gauze tracking; and (6) checklist compliance. Primary outcome measure was SSI, with secondary outcomes including other infection, re-operation, and length of stay. We prospectively observed all post-surgical wounds in obstetrics over a 12 day period and separately recorded post-operative complications using chart review. Simultaneously, we reviewed the written hospital charts after patient discharge for all patients whose peri-operative adherence to infection prevention standards was captured. Fifty obstetric patients were followed prospectively with recorded rates of SSI 14%, re-operation 6%, and death 2%. Compared with direct observation, chart review alone had a high loss to follow-up (28%) and decreased capture of infectious complications (SSI [n = 2], endometritis [n = 3], re-operations [n = 2], death [n = 1]); further, documentation inconsistencies failed to capture two complications (SSI [n = 1], mastitis [n = 1]). Concurrently, 137 patients were observed for peri-operative infection prevention standard adherence. Of these, we were able to successfully review 95 (69%) patient charts with recorded rates of SSI 5%, re-operation 1%, and death 1%. Patient loss to follow-up and poor documentation of infections underestimated overall infectious complications. Direct, prospective

[Dialin: infection surveillance network for haemodialysis patients. First results].

PubMed

Ayzac, Louis; Béruard, Michel; Girard, Raphaële; Hannoun, Jacques; Kuentz, François; Marc, Jean-Michel; Moreau-Gaudry, Xavier; Roche, Catherine; Tressières, Benoît; Uzan, Marc

2009-02-01

To show results of the first year of an infection surveillance network for haemodialysis patients (Dialin). In order to improve the security and quality of care, six haemodialysis centers have organized an infection watching network. The purpose of the network is to compare of the watching results between centers. This comparison includes vascular access infection (VAI), bacteraemia and C viral hepatitis. The heterogeneous pattern has been also taken into account. SURVEY TYPE: Multicenter prospective permanent survey. Six hundred and sixty-four haemodialyzed chronic patients, followed during one year (2005), in six voluntary haemodialysis centers. This survey has based on 71,688 treatment sessions corresponding to 6257.5 months of haemodialysis (HM). As with the heterogeneity among centers, the acquired infection standardized ratios (observed/expected) (AISR) and 95% confidence interval are computed with Cox model which includes confounding factors found in literature or in the preliminary stage of the survey. VAI crude rate was 0.47 per 100HM, 0.10 per 1000 native fistulae utilisation days, 0.45 per 1000 days of prosthetic graft utilisation and 0.44 per 1000 days of catheter utilisation. Bacteraemia crude incidence rate was 0.69 per 100HM, 0.02 per 1000 days of native fistulae utilisation, 0.00 per 1000 days of prosthetic graft utilisation and 0.39 per 1000 days of catheter utilisation. No new case of C viral hepatitis was found. Prevalence rate at the beginning of the survey was 5.3% (35 over 664). Two centers had a significantly high AISR for VAI and two centers had a significantly low AISR for VAI. One center had a significantly high AISR for bacteraemia and one center had a significantly low AISR for bacteraemia. The first year of Dialin running demonstrates the importance of standardised surveillance method in VAI and bacteraemia surveillance but not for viral hepatitis.

Validation of intensive care unit-acquired infection surveillance in the Italian SPIN-UTI network.

PubMed

Masia, M D; Barchitta, M; Liperi, G; Cantù, A P; Alliata, E; Auxilia, F; Torregrossa, V; Mura, I; Agodi, A

2010-10-01

Validity is one of the most critical factors concerning surveillance of nosocomial infections (NIs). This article describes the first validation study of the Italian Nosocomial Infections Surveillance in Intensive Care Units (ICUs) project (SPIN-UTI) surveillance data. The objective was to validate infection data and thus to determine the sensitivity, specificity, and positive and negative predictive values of NI data reported on patients in the ICUs participating in the SPIN-UTI network. A validation study was performed at the end of the surveillance period. All medical records including all clinical and laboratory data were reviewed retrospectively by the trained physicians of the validation team and a positive predictive value (PPV), a negative predictive value (NPV), sensitivity and specificity were calculated. Eight ICUs (16.3%) were randomly chosen from all 49 SPIN-UTI ICUs for the validation study. In total, the validation team reviewed 832 patient charts (27.3% of the SPIN-UTI patients). The PPV was 83.5% and the NPV was 97.3%. The overall sensitivity was 82.3% and overall specificity was 97.2%. Over- and under-reporting of NIs were related to misinterpretation of the case definitions and deviations from the protocol despite previous training and instructions. The results of this study are useful to identify methodological problems within a surveillance system and have been used to plan retraining for surveillance personnel and to design and implement the second phase of the SPIN-UTI project. Copyright 2010 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved.

Survey of Clostridium difficile infection surveillance systems in Europe, 2011.

PubMed

Kola, Axel; Wiuff, Camilla; Akerlund, Thomas; van Benthem, Birgit H; Coignard, Bruno; Lyytikäinen, Outi; Weitzel-Kage, Doris; Suetens, Carl; Wilcox, Mark H; Kuijper, Ed J; Gastmeier, Petra

2016-07-21

To develop a European surveillance protocol for Clostridium difficile infection (CDI), existing national CDI surveillance systems were assessed in 2011. A web-based electronic form was provided for all national coordinators of the European CDI Surveillance Network (ECDIS-Net). Of 35 national coordinators approached, 33 from 31 European countries replied. Surveillance of CDI was in place in 14 of the 31 countries, comprising 18 different nationwide systems. Three of 14 countries with CDI surveillance used public health notification of cases as the route of reporting, and in another three, reporting was limited to public health notification of cases of severe CDI. The CDI definitions published by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) and the European Centre for Disease Prevention and Control (ECDC) were widely used, but there were differing definitions to distinguish between community- and healthcare-associated cases. All CDI surveillance systems except one reported annual national CDI rates (calculated as number of cases per patient-days). Only four surveillance systems regularly integrated microbiological data (typing and susceptibility testing results). Surveillance methods varied considerably between countries, which emphasises the need for a harmonised European protocol to allow consistent monitoring of the CDI epidemiology at European level. The results of this survey were used to develop a harmonised EU-wide hospital-based CDI surveillance protocol. This article is copyright of The Authors, 2016.

[Surveillance on the prevalence of soil-transmitted nematode infection in Fujian in 2006-2010].

PubMed

Chen, Bao-jian; Li, Li-sha; Zhang, Rong-yan; Li, Yan-rong; Zhang, Zhi-fang; Zheng, Guo-bin; Fang, Yan-yan; Lin, Chen-xin; Jiang, Dian-wei

2012-02-29

To analyze the prevalent trend of soil-transmitted nematode infection in Fujian Province during the past 5 year surveillance and evaluate the control effect. From 2006 to 2010, fecal samples of the inhabitants of 3 years old and above were collected every November and examined for intestinal helminth eggs by the modified Kato s thick smear technique at the 2 surveillance sites: Punan village of Zhangzhou and Gushan village of Shaowu. Cellophane tapes were used to detect pinworm eggs for children aged 3-12. Soil samples were also collected from vegetable field, lavatory, courtyard and kitchen of 20 randomly selected families (in 2 villages) each with stool egg-positive findings and examined for ascaris eggs by a modified saturated sodium nitrate floatation method. The prevalence of soil-transmitted nematode infection at the surveillance sites decreased from 45.3% (946/2087) in 2006 to 15.1% (226/1494) in 2010, with a reduction of 66.6%. Among the infected subjects, hookworm infection occupied 75%-85%, while ascaris or trichuris infections each accounted for less than 10%. In terms of infection intensity, 65.2%-85.5% of the hookworm infection was light, and majority of the infected subjects were farmers. The pinworm prevalence in children were still high although it had dropped down from 46.1% (140/304) in 2006 to 29.8% (36/121) in 2010, declined by 35.4%. In the 5 years, totally 400 soil samples from 100 families were examined and 21 samples were found ascaris egg positive with viable eggs in only one sample. The 5 year surveillance reveals a decreasing trend of the soil-transmitted nematode prevalence but shows a relatively high hookworm infection rate in the population and pinworm infection in children.

Improving Surveillance and Prevention of Surgical Site Infection in Pediatric Cardiac Surgery.

PubMed

Cannon, Melissa; Hersey, Diane; Harrison, Sheilah; Joy, Brian; Naguib, Aymen; Galantowicz, Mark; Simsic, Janet

2016-03-01

Postoperative cardiovascular surgical site infections are preventable events that may lead to increased morbidity, mortality, and health care costs. To improve surgical wound surveillance and reduce the incidence of surgical site infections. An institutional review of surgical site infections led to implementation of 8 surveillance and process measures: appropriate preparation the night before surgery and the day of surgery, use of appropriate preparation solution in the operating room, appropriate timing of preoperative antibiotic administration, placement of a photograph of the surgical site in the patient's chart at discharge, sending a photograph of the surgical site to the patient's primary care physician, 30-day follow-up of the surgical site by an advanced nurse practitioner, and placing a photograph of the surgical site obtained on postoperative day 30 in the patient's chart. Mean overall compliance with the 8 measures from March 2013 through February 2014 was 88%. Infections occurred in 10 of 417 total operative cases (2%) in 2012, in 8 of 437 total operative cases (2%) in 2013, and in 7 of 452 total operative cases (1.5%) in 2014. Institution of the surveillance process has resulted in improved identification of suspected surgical site infections via direct rather than indirect measures, accurate identification of all surgical site infections based on definitions of the National Healthcare Safety Network, collaboration with all persons involved, and enhanced communication with patients' family members and referring physicians. ©2016 American Association of Critical-Care Nurses.

Active Surveillance Cultures and Decolonization to Reduce NICU Staphylococcus aureus Infections

PubMed Central

Popoola, Victor O.; Colantuoni, Elizabeth; Suwantarat, Nuntra; Pierce, Rebecca; Carroll, Karen C.; Aucott, Susan W.; Milstone, Aaron M.

2015-01-01

Background and Objectives Staphylococcus aureus (S. aureus) is a common cause of healthcare associated infections (HAI) in neonates. Our objectives were to examine the impact of S. aureus decolonization on the incidence of S. aureus infection and to measure the prevalence of mupirocin resistance. Methods We retrospectively identified neonates admitted to a tertiary care NICU between April 1 2011 and September 30 2014. We compared rates of MSSA-positive cultures and infections before and after implementation of active surveillance culture and decolonization intervention for MSSA-colonized neonates. We used two measurements to identify the primary outcome, NICU-attributable MSSA: 1) any culture sent during routine clinical care that grew MSSA and 2) any culture that grew MSSA and met criteria of the NHSN's HAI surveillance definitions. S. aureus isolates were tested for mupirocin susceptibility. To determine the impact of the intervention on MSSA infection, we estimated incidence rate ratios using interrupted time series models. Results Pre- and post-intervention, 1523 neonates (29,220 patient-days) and 1195 neonates (22,045 patient-days) were admitted to the NICU, respectively. There was an immediate reduction in mean quarterly incidence rate of NICU-attributable MSSA-positive clinical cultures, of more than 60% (IRR=0.36, 95% CI 0.19, 0.70) after implementation of the intervention and MSSA positive culture rates continued to decrease by 21% per quarter (IRR 0.79 95% CI 0.74, 0.84). MSSA infections also decreased immediately following the intervention implementation (IRR=0.27; 95% CI=0.10, 0.79). No mupirocin resistance was detected. Conclusions Active surveillance cultures and decolonization may be effective in decreasing S. aureus infections in NICUs. PMID:26725699

Integrated Multilevel Surveillance of the World's Infecting Microbes and Their Resistance to Antimicrobial Agents

PubMed Central

O'Brien, Thomas F.; Stelling, John

2011-01-01

Summary: Microbial surveillance systems have varied in their source of support; type of laboratory reporting (patient care or reference); inclusiveness of reports filed; extent of microbial typing; whether single hospital, multihospital, or multicountry; proportion of total medical centers participating; and types, levels, integration across levels, and automation of analyses performed. These surveillance systems variably support the diagnosis and treatment of patients, local or regional infection control, local or national policies and guidelines, laboratory capacity building, sentinel surveillance, and patient safety. Overall, however, only a small fraction of available data are under any surveillance, and very few data are fully integrated and analyzed. Advancing informatics and genomics can make microbial surveillance far more efficient and effective at preventing infections and improving their outcomes. The world's microbiology laboratories should upload their reports each day to programs that detect events, trends, and epidemics in communities, hospitals, countries, and the world. PMID:21482726

Sequential dengue virus infections detected in active and passive surveillance programs in Thailand, 1994-2010.

PubMed

Bhoomiboonchoo, Piraya; Nisalak, Ananda; Chansatiporn, Natkamol; Yoon, In-Kyu; Kalayanarooj, Siripen; Thipayamongkolgul, Mathuros; Endy, Timothy; Rothman, Alan L; Green, Sharone; Srikiatkhachorn, Anon; Buddhari, Darunee; Mammen, Mammen P; Gibbons, Robert V

2015-03-14

The effect of prior dengue virus (DENV) exposure on subsequent heterologous infection can be beneficial or detrimental depending on many factors including timing of infection. We sought to evaluate this effect by examining a large database of DENV infections captured by both active and passive surveillance encompassing a wide clinical spectrum of disease. We evaluated datasets from 17 years of hospital-based passive surveillance and nine years of cohort studies, including clinical and subclinical DENV infections, to assess the outcomes of sequential heterologous infections. Chi square or Fisher's exact test was used to compare proportions of infection outcomes such as disease severity; ANOVA was used for continuous variables. Multivariate logistic regression was used to assess risk factors for infection outcomes. Of 38,740 DENV infections, two or more infections were detected in 502 individuals; 14 had three infections. The mean ages at the time of the first and second detected infections were 7.6 ± 3.0 and 11.2 ± 3.0 years. The shortest time between sequential infections was 66 days. A longer time interval between sequential infections was associated with dengue hemorrhagic fever (DHF) in the second detected infection (OR 1.3, 95% CI 1.2-1.4). All possible sequential serotype pairs were observed among 201 subjects with DHF at the second detected infection, except DENV-4 followed by DENV-3. Among DENV infections detected in cohort subjects by active study surveillance and subsequent non-study hospital-based passive surveillance, hospitalization at the first detected infection increased the likelihood of hospitalization at the second detected infection. Increasing time between sequential DENV infections was associated with greater severity of the second detected infection, supporting the role of heterotypic immunity in both protection and enhancement. Hospitalization was positively associated between the first and second detected infections, suggesting

Improving the work efficiency of healthcare-associated infection surveillance using electronic medical records.

PubMed

Lo, Yu-Sheng; Lee, Wen-Sen; Chen, Guo-Bin; Liu, Chien-Tsai

2014-11-01

In this study, we developed an integrated hospital-associated urinary tract infection (HAUTI) surveillance information system (called iHAUTISIS) based on existing electronic medical records (EMR) systems for improving the work efficiency of infection control professionals (ICPs) in a 730-bed, tertiary-care teaching hospital in Taiwan. The iHAUTISIS can automatically collect data relevant to HAUTI surveillance from the different EMR systems, and provides a visualization dashboard that helps ICPs make better surveillance plans and facilitates their surveillance work. In order to measure the system performance, we also created a generic model for comparing the ICPs' work efficiency when using existing electronic culture-based surveillance information system (eCBSIS) and iHAUTISIS, respectively. This model can demonstrate a patient's state (unsuspected, suspected, and confirmed) and corresponding time spent on surveillance tasks performed by ICPs for the patient in that state. The study results showed that the iHAUTISIS performed better than the eCBSIS in terms of ICPs' time cost. It reduced the time by 73.27 s, when using iHAUTISIS (114.26 s) and eCBSIS (187.53 s), for each patient on average. With increased adoption of EMR systems, the development of the integrated HAI surveillance information systems would be more and more cost-effective. Moreover, the iHAUTISIS adopted web-based technology that enables ICPs to online access patient's surveillance information using laptops or mobile devices. Therefore, our system can further facilitate the HAI surveillance and reduce ICPs' surveillance workloads. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Vector borne infections in Italy: results of the integrated surveillance system for West Nile disease in 2013.

PubMed

Napoli, Christian; Iannetti, Simona; Rizzo, Caterina; Bella, Antonino; Di Sabatino, Daria; Bruno, Rossana; Sauro, Francesca; Martini, Vanessa; Santucci, Vincenzo Ugo; Declich, Silvia; Calistri, Paolo

2015-01-01

The epidemiology of West Nile disease (WND) is influenced by multiple ecological factors and, therefore, integrated surveillance systems are needed for early detecting the infection and activating consequent control actions. As different animal species have different importance in the maintenance and in the spread of the infection, a multispecies surveillance approach is required. An integrated and comprehensive surveillance system is in place in Italy aiming at early detecting the virus introduction, monitoring the possible infection spread, and implementing preventive measures for human health. This paper describes the integrated surveillance system for WND in Italy, which incorporates data from veterinary and human side in order to evaluate the burden of infection in animals and humans and provide the public health authorities at regional and national levels with the information needed for a fine tune response.

The Potential Contribution of BRCA Mutations to Early Onset and Familial Breast Cancer in Uzbekistan.

PubMed

Abdikhakimov, Abdulla; Tukhtaboeva, Mukaddas; Adilov, Bakhtiyar; Turdikulova, Shahlo

2016-01-01

Breast cancer is the most common malignancy in women and affects approximately 1 out of 8 females in the US. Risk of developing breast cancer is strongly influenced by genetic factors. Germ-line mutations in BRCA1 and BRCA2 genes are associated with 5-10% of breast cancer incidence. To reduce the risk of developing cancer and to increase the likelihood of early detection, carriers of BRCA1 or BRCA2 mutations are offered surveillance programs and effective preventive medical interventions. Identification of founder mutations of BRCA1/2 in high risk communities can have a significant impact on the management of hereditary cancer at the level of the national healthcare systems, making genetic testing more affordable and cost-effective. BRCA1 and BRCA2 mutations in breast cancer patients have not been characterized in the Uzbek population. This pilot study aimed to investigate the contribution of BRCA1 and BRCA2 mutation to early onset and familial cases of breast cancer in Uzbekistan. A total of 67 patients with breast cancer and 103 age-matched disease free controls were included in this study. Utilizing SYBR Green based real-time allele-specific PCR, we have analyzed DNA samples of patients with breast cancer and disease free controls to identify the following BRCA1 and BRCA2 mutations: BRCA1 5382insC, BRCA1 4153delA, BRCA1 185delAG, BRCA1 300T>G, BRCA2 6174delT. Three unrelated samples (4.5%) were found to be positive for the heterozygous 5382insCBRCA1 mutation, representing a possible founder mutation in the Uzbek population, supporting the need for larger studies examining the contribution of this mutation to breast cancer incidence in Uzbekistan. We did not find BRCA1 4153delA, BRCA1 185delAG, BRCA1 300T>G, and BRCA2 6174delT mutations. This preliminary evidence suggests a potential contribution of BRCA1 5382insC mutation to breast cancer development in Uzbek population. Taking into account a high disease penetrance in carriers of BRCA1 mutation, it seems

Twenty-year summary of surveillance for human hantavirus infections, United States.

PubMed

Knust, Barbara; Rollin, Pierre E

2013-12-01

In the past 20 years of surveillance for hantavirus in humans in the United States, 624 cases of hantavirus pulmonary syndrome (HPS) have been reported, 96% of which occurred in states west of the Mississippi River. Most hantavirus infections are caused by Sin Nombre virus, but cases of HPS caused by Bayou, Black Creek Canal, Monongahela, and New York viruses have been reported, and cases of domestically acquired hemorrhagic fever and renal syndrome caused by Seoul virus have also occurred. Rarely, hantavirus infections result in mild illness that does not progress to HPS. Continued testing and surveillance of clinical cases in humans will improve our understanding of the etiologic agents involved and the spectrum of diseases.

Increasing Antimicrobial Resistance Monitored in Surveillance Analysis of Blood Stream Infections in Febrile Neutropenic Pediatric Oncology Patients.

PubMed

El-Mahallawy, Hadir A; Hassan, Safaa Shawky; El-Wakil, Mohamed; Moneer, Manar M; Shalaby, Lobna

2015-01-01

Continuous surveillance of pattern of blood stream infection is necessary in febrile neutropenia (FN)especially with the recent escalating trend in the management of pediatric cancer patients towards intensified regimens and with the increase in infections caused by resistant organisms limiting the choice of antibiotics. To monitor change in pattern of blood stream infections (BSI) in FN pediatric cancer patients. Surveillance of FN episodes with positive BSI was prospectively monitored and compared to a previous surveillance in the same pediatric oncology unit. A total of 232 BSI positive episodes were documented in 192 patients during a 6 months period. The results of recent surveillance analysis showed an increase in intensified regimens of chemotherapy, antimicrobial resistance, fungal infections, and prolonged duration of episodes when compared to previous surveillance, with p value sof <0.001, 0.005, 0.021, and <0.001, respectively. There was an apparent decrease in the crude mortality but this was not statistically significant, to 6% in 2011 from 10 % in 2006. The pattern of BSI at our institution is still inclining towards gram positive organisms but is showing a shift towards more antibiotic resistance and fungal infections.

Vector Borne Infections in Italy: Results of the Integrated Surveillance System for West Nile Disease in 2013

PubMed Central

Napoli, Christian; Di Sabatino, Daria; Martini, Vanessa; Santucci, Vincenzo Ugo; Declich, Silvia

2015-01-01

The epidemiology of West Nile disease (WND) is influenced by multiple ecological factors and, therefore, integrated surveillance systems are needed for early detecting the infection and activating consequent control actions. As different animal species have different importance in the maintenance and in the spread of the infection, a multispecies surveillance approach is required. An integrated and comprehensive surveillance system is in place in Italy aiming at early detecting the virus introduction, monitoring the possible infection spread, and implementing preventive measures for human health. This paper describes the integrated surveillance system for WND in Italy, which incorporates data from veterinary and human side in order to evaluate the burden of infection in animals and humans and provide the public health authorities at regional and national levels with the information needed for a fine tune response. PMID:25874224

Introduction of software tools for epidemiological surveillance in infection control in Colombia

PubMed Central

Motoa, Gabriel; Vallejo, Marta; Blanco, Víctor M; Correa, Adriana; de la Cadena, Elsa; Villegas, María Virginia

2015-01-01

Introduction: Healthcare-Associated Infections (HAI) are a challenge for patient safety in the hospitals. Infection control committees (ICC) should follow CDC definitions when monitoring HAI. The handmade method of epidemiological surveillance (ES) may affect the sensitivity and specificity of the monitoring system, while electronic surveillance can improve the performance, quality and traceability of recorded information. Objective: To assess the implementation of a strategy for electronic surveillance of HAI, Bacterial Resistance and Antimicrobial Consumption by the ICC of 23 high-complexity clinics and hospitals in Colombia, during the period 2012-2013. Methods: An observational study evaluating the introduction of electronic tools in the ICC was performed; we evaluated the structure and operation of the ICC, the degree of incorporation of the software HAI Solutions and the adherence to record the required information. Results: Thirty-eight percent of hospitals (8/23) had active surveillance strategies with standard criteria of the CDC, and 87% of institutions adhered to the module of identification of cases using the HAI Solutions software. In contrast, compliance with the diligence of the risk factors for device-associated HAIs was 33%. Conclusions: The introduction of ES could achieve greater adherence to a model of active surveillance, standardized and prospective, helping to improve the validity and quality of the recorded information. PMID:26309340

Introduction of software tools for epidemiological surveillance in infection control in Colombia.

PubMed

Hernández-Gómez, Cristhian; Motoa, Gabriel; Vallejo, Marta; Blanco, Víctor M; Correa, Adriana; de la Cadena, Elsa; Villegas, María Virginia

2015-01-01

Healthcare-Associated Infections (HAI) are a challenge for patient safety in the hospitals. Infection control committees (ICC) should follow CDC definitions when monitoring HAI. The handmade method of epidemiological surveillance (ES) may affect the sensitivity and specificity of the monitoring system, while electronic surveillance can improve the performance, quality and traceability of recorded information. To assess the implementation of a strategy for electronic surveillance of HAI, Bacterial Resistance and Antimicrobial Consumption by the ICC of 23 high-complexity clinics and hospitals in Colombia, during the period 2012-2013. An observational study evaluating the introduction of electronic tools in the ICC was performed; we evaluated the structure and operation of the ICC, the degree of incorporation of the software HAI Solutions and the adherence to record the required information. Thirty-eight percent of hospitals (8/23) had active surveillance strategies with standard criteria of the CDC, and 87% of institutions adhered to the module of identification of cases using the HAI Solutions software. In contrast, compliance with the diligence of the risk factors for device-associated HAIs was 33%. The introduction of ES could achieve greater adherence to a model of active surveillance, standardized and prospective, helping to improve the validity and quality of the recorded information.

An assessment of public health surveillance of Zika virus infection and potentially associated outcomes in Latin America.

PubMed

Bautista, Leonelo E; Herrera, Víctor M

2018-05-24

We evaluated whether outbreaks of Zika virus (ZIKV) infection, newborn microcephaly, and Guillain-Barré syndrome (GBS) in Latin America may be detected through current surveillance systems, and how cases detected through surveillance may increase health care burden. We estimated the sensitivity and specificity of surveillance case definitions using published data. We assumed a 10% ZIKV infection risk during a non-outbreak period and hypothetical increases in risk during an outbreak period. We used sensitivity and specificity estimates to correct for non-differential misclassification, and calculated a misclassification-corrected relative risk comparing both periods. To identify the smallest hypothetical increase in risk resulting in a detectable outbreak we compared the misclassification-corrected relative risk to the relative risk corresponding to the upper limit of the endemic channel (mean + 2 SD). We also estimated the proportion of false positive cases detected during the outbreak. We followed the same approach for microcephaly and GBS, but assumed the risk of ZIKV infection doubled during the outbreak, and ZIKV infection increased the risk of both diseases. ZIKV infection outbreaks were not detectable through non-serological surveillance. Outbreaks were detectable through serologic surveillance if infection risk increased by at least 10%, but more than 50% of all cases were false positive. Outbreaks of severe microcephaly were detected if ZIKV infection increased prevalence of this condition by at least 24.0 times. When ZIKV infection did not increase the prevalence of severe microcephaly, 34.7 to 82.5% of all cases were false positive, depending on diagnostic accuracy. GBS outbreaks were detected if ZIKV infection increased the GBS risk by at least seven times. For optimal GBS diagnosis accuracy, the proportion of false positive cases ranged from 29 to 54% and from 45 to 56% depending on the incidence of GBS mimics. Current surveillance systems have a

Annual Surveillance Summary: Vancomycin-Resistant Enterococci (VRE) Infections in the Military Health System (MHS), 2015

DTIC Science & Technology

2017-03-01

Defense (DOD) and Department of the Navy (DON) active duty (AD) service members with deployment-related infections. In 2015, the annual VRE incidence rate...reporting of resistant strains.9 Additionally, active surveillance of high-risk patients has been cited as a pertinent control measure in healthcare...settings; one study demonstrated active surveillance with contact precautions prevented VRE infections in an intensive care unit (ICU) where 100% of

Addressing the need for an infection prevention and control framework that incorporates the role of surveillance: a discussion paper.

PubMed

Mitchell, Brett G; Gardner, Anne

2014-03-01

To present a discussion on theoretical frameworks in infection prevention and control. Infection prevention and control programmes have been in place for several years in response to the incidence of healthcare-associated infections and their associated morbidity and mortality. Theoretical frameworks play an important role in formalizing the understanding of infection prevention activities. Discussion paper. A literature search using electronic databases was conducted for published articles in English addressing theoretical frameworks in infection prevention and control between 1980-2012. Nineteen papers that included a reference to frameworks were identified in the review. A narrative analysis of these papers was completed. Two models were identified and neither included the role of surveillance. To reduce the risk of acquiring a healthcare-associated infection, a multifaceted approach to infection prevention is required. One key component in this approach is surveillance. The review identified two infection prevention and control frameworks, yet these are rarely applied in infection prevention and control programmes. Only one framework considered the multifaceted approach required for infection prevention. It did not, however, incorporate the role of surveillance. We present a framework that incorporates the role of surveillance into a biopsychosocial approach to infection prevention and control. Infection prevention and control programmes and associated research are led primarily by nurses. There is a need for an explicit infection prevention and control framework incorporating the important role that surveillance has in infection prevention activities. This study presents one framework for further critique and discussion. © 2013 John Wiley & Sons Ltd.

Horizontal infection control strategy decreases methicillin-resistant Staphylococcus aureus infection and eliminates bacteremia in a surgical ICU without active surveillance.

PubMed

Traa, Maria X; Barboza, Lorena; Doron, Shira; Snydman, David R; Noubary, Farzad; Nasraway, Stanley A

2014-10-01

Methicillin-resistant Staphylococcus aureus infection is a significant contributor to morbidity and mortality in hospitalized patients worldwide. Numerous healthcare bodies in Europe and the United States have championed active surveillance per the "search and destroy" model. However, this strategy is associated with significant economic, logistical, and patient costs without any impact on other hospital-acquired pathogens. We evaluated whether horizontal infection control strategies could decrease the prevalence of methicillin-resistant S. aureus infection in the ICU, without the need for active surveillance. Retrospective, observational study in the surgical ICU of a tertiary care medical center in Boston, MA, from 2005 to 2012. A total of 6,697 patients in the surgical ICU. Evidence-based infection prevention strategies were implemented in an iterative fashion, including 1) hand hygiene program with refresher education campaign, 2) chlorhexidine oral hygiene program, 3) chlorhexidine bathing, 4) catheter-associated bloodstream infection program, and 5) daily goals sheets. The prevalence of methicillin-resistant S. aureus infection fell from 2.66 to 0.69 per 1,000 patient days from 2005 to 2012, an average decrease of 21% per year. The biggest decline in rate of infection was detected in 2008, which may suggest that the catheter-associated bloodstream infection prevention program was particularly effective. Among 4,478 surgical ICU admissions over the last 5 years, not a single case of methicillin-resistant S. aureus bacteremia was observed. Aggressive multifaceted horizontal infection control is an effective strategy for reducing the prevalence of methicillin-resistant S. aureus infection and eliminating methicillin-resistant S. aureus bacteremia in the ICU without the need for active surveillance and decontamination.

Human surveillance for West Nile virus infection in Ontario in 2000

PubMed Central

Ford-Jones, E. Lee; Fearon, Margaret; Leber, Chuck; Dwight, Prabo; Myszak, Moira; Cole, Beverly; Greene, Pam Baker; Artes, Sheila; McGeer, Allison; D'Cunha, Colin; Naus, Monika

2002-01-01

Background The first reports of West Nile virus (WNV) infection in the United States in 1999 prompted Ontario to establish a surveillance protocol to monitor for the possible spread of the virus into the province. Surveillance components included evaluation of dead birds, sentinel chickens, mosquito pools and human disease. We report the results of human surveillance in 2000. Methods Between July 1 and Oct. 31, 2000, an active surveillance program was undertaken in which designated site coordinators in sentinel hospitals identified patients who met the suspect case definition (fever and fluctuating level of consciousness [encephalopathy], with or without muscle weakness). During the same period, following province-wide distribution of educational material, all other patients tested for WNV antibodies were identified through review of provincial laboratory reports (laboratory-based enhanced passive surveillance). Results Of the 60 hospitals contacted, 59 agreed to participate in the active surveillance program; 52 provided information on a regular (weekly) basis, and 7 submitted fewer than 8 reports. Thirty-six (61%) of the sentinel sites reported suspect cases. In total, 188 patients were tested (130 identified through active surveillance and 58 through enhanced passive surveillance). Patients identified through active surveillance were more likely than those identified through passive surveillance to meet the suspect case definition (43% [n = 56] v. 7% [n = 4]), to be admitted to hospital (75% [n = 99] v. 16% [n = 9]), to have a longer hospital stay (mean 25 v. 3 days), to have had a second (convalescent) serum sample collected (37% [n = 48] v. 31% [n = 18]), to have had a cerebrospinal fluid (CSF) sample banked (56% [n = 73] v. 14% [n = 8]) and to have had a discharge diagnosis reported (79% [n = 103] v. 28% [n = 16]). Of the 60 patients (32%) who met the suspect case definition, 34 (57% [31 active, 3 passive]) had a discharge diagnosis of encephalitis. Of these

Westernmost Tian Shan (Uzbekistan): Magmatism and Exhumation

NASA Astrophysics Data System (ADS)

Abdulhameed, Sanaa; Ratchbacher, Lothar; Gagala, Lukasz; Jonkheere, Raymond

2014-05-01

The westernmost segment of the Tian Shan comprises the Ghissar-Alai Range of Tajikistan and Uzbekistan; its southwestern promontory contains the Baysunta crystalline massif. This orocline extends northwest of the Pamir and southeast of the Turan platform and forms the (north) western margin of the intra-orogenic Afghan-Tajik basin that was inverted during the India-Asia collision, mainly as a result of the gravitational collapse of the Pamir Plateau. The area contains Paleozoic slope and shelf clastics mantling crystalline basement rocks, altogether intruded by massif granitoids; it hides the cryptic Late Paleozoic South Ghissar suture. In Uzbekistan, the crystalline basement rocks of the westernmost Tien Shan are involved in the folding and thrusting of the Jurassic to Neogene sediments of the Afghan-Tajik basin, spectacularly proving thick-skinned deformation and demonstrating basement involvement below the Jurassic evaporate décollement underneath the Afghan-Tajik basin. We sampled the crystalline basement rocks of the Tian Shan of Uzbekistan to constrain the formation of the enigmatic Baysunta block and date the crystallization and high-grade metamorphism of the granitoids and associated metamorphic rocks of the Ghissar range; we employed U-Pb zircon geochronology. To time the deformation and exhumation of the fold-and thrust belt of the westernmost Afghan-Tajik basin, we used apatite fission-track thermochronology. Concordant U-Pb crystallization ages of zircons in the orthogneiss and paragneiss comprise 620 to 300 Ma; the Neoproterozoic ages imply a correlation of the Baysunta block with the Garm crystalline massif of the central Ghissar-Alai range of northeastern Tajikistan. The youngest zircon crystallization ages from granitoids are ~220 Ma, revealing enigmatically young magmatism, post-dating the last known collision event by >50 Ma. Together with 270-240 Ma meta-basaltic dykes and stocks in Tajikistan, they may trace a regional post

[Surveillance of infection events in neonatal intensive care].

PubMed

Decembrino, L; Perrini, S; Stronati, M

2010-06-01

Nosocomial infections are one of the major causes of morbidity and mortality in the newborn intensive care unit (NICU). They result in prolonged hospital stays and increased hospital costs. Neonates are susceptible hosts because of prematurity of organ systems, immaturity of immune system, low birth weight and the use of invasive devices. Most infections are endemic others can occur during outbreaks. As advances in medical technology improve mortality in the tiniest of infants, it is imperative that health care providers identify effective interventions to minimize the risks of nosocomial infections in the NICU. Recommended infection control and prevention strategies are: hand washing promotion, decreased use of invasive procedures, limited antitibiotic exposure, environmental hygiene. In this context infection surveillance is the first step to recognize and analyze problems, to effectively target infection control measures and feedback. Any suspicion of an outbreak should lead to a review of general infection control procedures to prevent the spread of the pathogens as quickly as possible. A multidisciplinary approach can be an effective means of developing a plan of action to apply prolonged and strict adherence to isolation precautions', to detect potential reservoirs or source of infections, to educate every member of the patient care team and to review NICU protocols.

[Surveillance and forecast for schistosome infectivity of Yangtze River and Hanbeihe River during flooding in Hubei Province].

PubMed

Tu, Zu-Wu; Cai, Shun-Xiang; Huang, Xi-Bao; Su, Zheng-Ming; Gao, Hua; Chen, Yan-Yan; Cao, Mu-Min; Mao, Guan-Xiang; Xia, Ping-Feng

2012-04-01

To investigate the schistosome infectivity of the water body of the Yangtze River and Hanbeihe River during flooding in Hubei Province. The Oncomelania snail status was investigated in 17 sites of the Yangtze River and Hanbei River, and the infectivity of schistosome in sentinel mice was also determined. In the Yangtze River and Hanbei River, the average densities of living snails were 0.35 snails/0.1 m2 and 0.67 snails/0.1 m2 respectively, and the average infection rates of snails were 0.33% and 0.05%, respectively. The sentinel mouse surveillances were carried out twice in 10 sites of the Yangtze River. During the first surveillance the infection rate was 5.5% with 4 positive environment sites, and that was 5.5% with 7 positive environment sites in the second surveillance. The sentinel mouse surveillance was carried out once in 7 sites of the Hanbeihe River, and the infection rate was 11.9% with 4 positive environment sites. By monitoring schistosome infection of the water body, we can understand the threat of environment and provide warning information to prevent from the outbreak and spread of acute schistosomiasis. We can also indirectly get many messages about the quality of snail investigation and the effect of mollusciciding.

Characteristics of national and statewide health care-associated infection surveillance programs: A qualitative study.

PubMed

Russo, Philip L; Havers, Sally M; Cheng, Allen C; Richards, Michael; Graves, Nicholas; Hall, Lisa

2016-12-01

There are many well-established national health care-associated infection surveillance programs (HAISPs). Although validation studies have described data quality, there is little research describing important characteristics of large HAISPs. The aim of this study was to broaden our understanding and identify key characteristics of large HAISPs. Semi-structured interviews were conducted with purposively selected leaders from national and state-based HAISPs. Interview data were analyzed following an interpretive description process. Seven semi-structured interviews were conducted over a 6-month period during 2014-2015. Analysis of the data generated 5 distinct characteristics of large HAISPs: (1) triggers: surveillance was initiated by government or a cooperative of like-minded people, (2) purpose: a clear purpose is needed and determines other surveillance mechanisms, (3) data measures: consistency is more important than accuracy, (4) processes: a balance exists between the volume of data collected and resources, and (5) implementation and maintenance: a central coordinating body is crucial for uniformity and support. National HAISPs are complex and affect a broad range of stakeholders. Although the overall goal of health care-associated infection surveillance is to reduce the incidence of health care-associated infection, there are many crucial factors to be considered in attaining this goal. The findings from this study will assist the development of new HAISPs and could be used as an adjunct to evaluate existing programs. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Hepatitis E virus infection in Europe: surveillance and descriptive epidemiology of confirmed cases, 2005 to 2015.

PubMed

Aspinall, Esther J; Couturier, Elisabeth; Faber, Mirko; Said, Bengü; Ijaz, Samreen; Tavoschi, Lara; Takkinen, Johanna; Adlhoch, Cornelia

2017-06-29

Hepatitis E virus (HEV) is an under-recognised cause of acute hepatitis in high-income countries. The purpose of this study was to provide an overview of testing, diagnosis, surveillance activities, and data on confirmed cases in the European Union/European Economic Area (EU/EEA). A semi-structured survey was developed and sent to 31 EU/EEA countries in February 2016, 30 responded. Twenty of these countries reported that they have specific surveillance systems for HEV infection. Applied specific case definition for HEV infection varied widely across countries. The number of reported cases has increased from 514 cases per year in 2005 to 5,617 in 2015, with most infections being locally acquired. This increase could not be explained by additional countries implementing surveillance for HEV infections over time. Hospitalisations increased from less than 100 in 2005 to more than 1,100 in 2015 and 28 fatal cases were reported over the study period. EU/EEA countries are at different stages in their surveillance, testing schemes and policy response to the emergence of HEV infection in humans. The available data demonstrated a Europe-wide increase in cases. Standardised case definitions and testing policies would allow a better understanding of the epidemiology of HEV as an emerging cause of liver-related morbidity. This article is copyright of The Authors, 2017.

Efforts of Uzbekistan to prevent nuclear terrorism and smuggling of radioactive and nuclear materials.

PubMed

Petrenko, V D; Karimov, Yu N; Podkovirin, A I; Shipilov, N N; Yuldashev, B S; Fazylov, M I

2005-01-01

Uzbekistan is located on the cross-roads from the north--Russia, Western Europe--to the south--Afghanistan, Iran, Iraq and others. The appearance of terrorist organizations urged some Asian countries to make the nuclear weapons, the making the task of stopping the transportation of nuclear materials and technologies from the north (from countries possessing nuclear weapon) to the south (to countries desiring to have weapons and its components) a reality. To resolve this problem, on the main transportation routes, "Yantar" stationary radiation monitors of Russian production were installed, and development and production of monitors of our own make was started. This paper covers these works as well as those on preventing possible terrorist attacks on nuclear objects of Uzbekistan.

Where on Earth...? MISR Mystery Image Quiz #13: Western Uzbekistan and Northeastern Turkmenistan

NASA Image and Video Library

2003-03-19

Acquired by the Multi-angle Imaging SpectroRadiometer instrument aboard NASA Terra spacecraft, this image is from the MISR Where on Earth...? Mystery Quiz #13. The location is Western Uzbekistan and Northeastern Turkmenistan.

Training initiatives within the AFHSC-Global Emerging Infections Surveillance and Response System: support for IHR (2005)

PubMed Central

2011-01-01

Training is a key component of building capacity for public health surveillance and response, but has often been difficult to quantify. During fiscal 2009, the Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) supported 18 partner organizations in conducting 123 training initiatives in 40 countries for 3,130 U.S. military, civilian and host-country personnel. The training assisted with supporting compliance with International Health Regulations, IHR (2005). Training activities in pandemic preparedness, outbreak investigation and response, emerging infectious disease (EID) surveillance and pathogen diagnostic techniques were expanded significantly. By engaging local health and other government officials and civilian institutions, the U.S. military’s role as a key stakeholder in global public health has been strengthened and has contributed to EID-related surveillance, research and capacity-building initiatives specified elsewhere in this issue. Public health and emerging infections surveillance training accomplished by AFHSC-GEIS and its Department of Defense (DoD) partners during fiscal 2009 will be tabulated and described. PMID:21388565

Healthcare associated infections in neonatal intensive care unit and its correlation with environmental surveillance.

PubMed

Kumar, Sanjay; Shankar, Binoy; Arya, Sugandha; Deb, Manorma; Chellani, Harish

Healthcare-associated infections (HAI) are frequent complications in neonatal intensive care units (NICU) with varying risk factors and bacteriological profile. There is paucity of literature comparing the bacteriological profile of organisms causing HAI with the environmental surveillance isolates. Therefore, this study aimed to evaluate demographic profile, risk factors and outcome of HAI in NICU and correlate with environmental surveillance. Three hundred newborns with signs and symptoms of sepsis were enrolled in the study group and their profile, risk factors and outcome were compared with the control group. Univariate analysis and multivariable logistic regression were performed. Environmental surveillance results were compared to the bacteriological profile of HAIs. We identified lower gestational age, male gender and apgar score less than 7 at 5min, use of peripheral vascular catheter & ventilator along with their duration as significant risk factors. Mortality rate was 29% in the study group (p<0.05). The HAI site distribution showed blood-stream infections (73%) to be the most common followed by pneumonia (12%) and meningitis (10%). Gram positive cocci were the most common isolates in HAI as well as environmental surveillance. The bacteriological profile of HAI correlates with the environmental surveillance report thus insisting for periodic surveillance and thereby avoiding irrational antibiotic usage. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

A Web-Based, Hospital-Wide Health Care-Associated Bloodstream Infection Surveillance and Classification System: Development and Evaluation.

PubMed

Tseng, Yi-Ju; Wu, Jung-Hsuan; Lin, Hui-Chi; Chen, Ming-Yuan; Ping, Xiao-Ou; Sun, Chun-Chuan; Shang, Rung-Ji; Sheng, Wang-Huei; Chen, Yee-Chun; Lai, Feipei; Chang, Shan-Chwen

2015-09-21

Surveillance of health care-associated infections is an essential component of infection prevention programs, but conventional systems are labor intensive and performance dependent. To develop an automatic surveillance and classification system for health care-associated bloodstream infection (HABSI), and to evaluate its performance by comparing it with a conventional infection control personnel (ICP)-based surveillance system. We developed a Web-based system that was integrated into the medical information system of a 2200-bed teaching hospital in Taiwan. The system automatically detects and classifies HABSIs. In this study, the number of computer-detected HABSIs correlated closely with the number of HABSIs detected by ICP by department (n=20; r=.999 P<.001) and by time (n=14; r=.941; P<.001). Compared with reference standards, this system performed excellently with regard to sensitivity (98.16%), specificity (99.96%), positive predictive value (95.81%), and negative predictive value (99.98%). The system enabled decreasing the delay in confirmation of HABSI cases, on average, by 29 days. This system provides reliable and objective HABSI data for quality indicators, improving the delay caused by a conventional surveillance system.

Epidemiology of UK neonatal infections: the neonIN infection surveillance network.

PubMed

Cailes, Benjamin; Kortsalioudaki, Christina; Buttery, Jim; Pattnayak, Santosh; Greenough, Anne; Matthes, Jean; Bedford Russell, Alison; Kennea, Nigel; Heath, Paul T

2017-12-05

To describe the epidemiology of neonatal infection over the past decade in UK neonatal units. Retrospective analysis of prospectively collected infection surveillance network data from 2005 to 2014. 30 neonatal units in the UK. Newborns on participating neonatal units who had a positive blood, cerebrospinal fluid or urine culture and were treated with at least 5 days of appropriate antibiotics. 2171 episodes of neonatal infection in 1922 infants were recorded. The incidence of infection was 6.1/1000 live births and 48.8/1000 neonatal admissions (2.9 and 23.5 respectively if coagulase-negative staphylococci (CoNS) cultures excluded). The incidence of infection showed a statistically significant reduction over time with reductions in the rates of both early-onset sepsis (EOS) and late-onset sepsis (LOS).The majority of episodes (76%) represented LOS (diagnosed > 48 hours after birth), and infection was more common in premature (<37 weeks gestation) and low birth weight (<2500 g) neonates (84% and 81%, respectively). Commonly identified pathogens included group B streptococci (43%) and Escherichia coli (18%) for EOS, while E. coli (15%), Staphylococcus aureus (14%) and CoNS were prominent causes of LOS. This paper describes the epidemiology of neonatal infection in the UK over the past decade. These data enable benchmarking of practice and inform areas of future research and guideline development. The results support the hypothesis that the introduction of infection prevention care bundles and antibiotic stewardship programmes in the UK has reduced the burden of LOS. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Invasive fungal infections among organ transplant recipients: results of the Transplant-Associated Infection Surveillance Network (TRANSNET).

PubMed

Pappas, Peter G; Alexander, Barbara D; Andes, David R; Hadley, Susan; Kauffman, Carol A; Freifeld, Alison; Anaissie, Elias J; Brumble, Lisa M; Herwaldt, Loreen; Ito, James; Kontoyiannis, Dimitrios P; Lyon, G Marshall; Marr, Kieren A; Morrison, Vicki A; Park, Benjamin J; Patterson, Thomas F; Perl, Trish M; Oster, Robert A; Schuster, Mindy G; Walker, Randall; Walsh, Thomas J; Wannemuehler, Kathleen A; Chiller, Tom M

2010-04-15

Invasive fungal infections (IFIs) are a major cause of morbidity and mortality among organ transplant recipients. Multicenter prospective surveillance data to determine disease burden and secular trends are lacking. The Transplant-Associated Infection Surveillance Network (TRANSNET) is a consortium of 23 US transplant centers, including 15 that contributed to the organ transplant recipient dataset. We prospectively identified IFIs among organ transplant recipients from March, 2001 through March, 2006 at these sites. To explore trends, we calculated the 12-month cumulative incidence among 9 sequential cohorts. During the surveillance period, 1208 IFIs were identified among 1063 organ transplant recipients. The most common IFIs were invasive candidiasis (53%), invasive aspergillosis (19%), cryptococcosis (8%), non-Aspergillus molds (8%), endemic fungi (5%), and zygomycosis (2%). Median time to onset of candidiasis, aspergillosis, and cryptococcosis was 103, 184, and 575 days, respectively. Among a cohort of 16,808 patients who underwent transplantation between March 2001 and September 2005 and were followed through March 2006, a total of 729 IFIs were reported among 633 persons. One-year cumulative incidences of the first IFI were 11.6%, 8.6%, 4.7%, 4.0%, 3.4%, and 1.3% for small bowel, lung, liver, heart, pancreas, and kidney transplant recipients, respectively. One-year incidence was highest for invasive candidiasis (1.95%) and aspergillosis (0.65%). Trend analysis showed a slight increase in cumulative incidence from 2002 to 2005. We detected a slight increase in IFIs during the surveillance period. These data provide important insights into the timing and incidence of IFIs among organ transplant recipients, which can help to focus effective prevention and treatment strategies.

Climate related natural hazards management in the vulnerable regions of Uzbekistan - experiences in the frame of projects Climate Risk Management in Uzbekistan (CRM-Uz) and Water in Central Asia (CAWa)

NASA Astrophysics Data System (ADS)

Merkushkin, Alexander; Gafurov, Abror; Agaltseva, Natalya; Pak, Alexander; Mannig, Birgit; Paeth, Heiko; Vorogushyn, Sergiy; Unger-Shayesteh, Katy

2014-05-01

Increased frequency of natural hazards under conditions of observed climate change in Uzbekistan has become challenging concern and shows the need to develop more effective climate risk mechanisms towards improving the security of society and sustainable development. In the framework of presented study, the importance of drought monitoring and methodologies for early warning for such purposes in Uzbekistan are demonstrated. For the conditions of Uzbekistan, droughts are most dangerous climate related natural phenomenon. Therefore, the CRM-Uz Project on Climate Risk Management was established with focus on reducing climate risks, strengthening adaptive capacity for stimulating the development of early warning mechanisms, as well as to build up the basis for long-term investments. This serves to increase resilience to climate impacts in the country. In the frame of the CRM-Uz Project, Drought Early Warning System (DEWS), has been developed and implemented in one of the southern provinces of Uzbekistan (Kashkadarya). The main task of DEWS is to provide population with information on the possibility of upcoming drought season in advance. DEWS is used for the assessment, monitoring, prevention, early warning and decision making in this region. Such early warning system provides the required information to undertake appropriate measures against drought and to mitigate its adverse effects to society. It is clear that during years with expected drought the hydrological forecasts become much more important. Complex mathematical model which simulates of run-off formation as a basis of DEWS provides the seasonal hydrological forecasts that are used to inform all concerned sectors, especially the agricultural sector on water availability during the vegetation period. In the frame of cooperation with German Research Centre for Geosciences (GFZ) within the CAWa Project, the DEWS was extended through implementation of MODSNOW - the operational tool for snow cover monitoring at

Impact of revising the National Nosocomial Infection Surveillance System definition for catheter-related bloodstream infection in ICU: reproducibility of the National Healthcare Safety Network case definition in an Australian cohort of infection control professionals.

PubMed

Worth, Leon J; Brett, Judy; Bull, Ann L; McBryde, Emma S; Russo, Philip L; Richards, Michael J

2009-10-01

Effective and comparable surveillance for central venous catheter-related bloodstream infections (CLABSIs) in the intensive care unit requires a reproducible case definition that can be readily applied by infection control professionals. Using a questionnaire containing clinical cases, reproducibility of the National Nosocomial Infection Surveillance System (NNIS) surveillance definition for CLABSI was assessed in an Australian cohort of infection control professionals participating in the Victorian Hospital Acquired Infection Surveillance System (VICNISS). The same questionnaire was then used to evaluate the reproducibility of the National Healthcare Safety Network (NHSN) surveillance definition for CLABSI. Target hospitals were defined as large metropolitan (1A) or other large hospitals (non-1A), according to the Victorian Department of Human Services. Questionnaire responses of Centers for Disease Control and Prevention NHSN surveillance experts were used as gold standard comparator. Eighteen of 21 eligible VICNISS centers participated in the survey. Overall concordance with the gold standard was 57.1%, and agreement was highest for 1A hospitals (60.6%). The proportion of congruently classified cases varied according to NNIS criteria: criterion 1 (recognized pathogen), 52.8%; criterion 2a (skin contaminant in 2 or more blood cultures), 83.3%; criterion 2b (skin contaminant in 1 blood culture and appropriate antimicrobial therapy instituted), 58.3%; non-CLABSI cases, 51.4%. When survey questions regarding identification of cases of CLABSI criterion 2b were removed (consistent with the current NHSN definition), overall percentage concordance increased to 62.5% (72.2% for 1A centers). Further educational interventions are required to improve the discrimination of primary and secondary causes of bloodstream infection in Victorian intensive care units. Although reproducibility of the CLABSI case definition is relatively poor, adoption of the revised NHSN definition

Statistical characteristics of mudflows in the piedmont areas of Uzbekistan and the role of the synoptic processes for the formation of mudflows

NASA Astrophysics Data System (ADS)

Mamadjanova, Gavkhar; Leckebusch, Gregor C.

2016-04-01

Mudflows are formed almost every year in the territory of Uzbekistan and neighbouring countries. They represent a major threat to human life and settlements and can significantly damage infrastructure. In general, in addition to elevated soil moisture conditions, severe local rainfall events (e.g., 15 mm of precipitation in 12 hours) and associated air temperature conditions are understood to be the main factors in the formation of mudflows in the piedmont areas of Uzbekistan. The main purpose of this study is to understand factors on local and synoptic to hemispheric scales, which cause mudflow variability on interannual and longer time scales. To fulfil this objective, in a first step historical data of mudflow occurrences (mainly March to August) in Uzbekistan provided by the Centre of Hydro-meteorological Service of the Republic of Uzbekistan (Uzhydromet) for more than 140 years are statistically analysed. During the investigation period a total of around 3000 mudflow events were observed with about 21 events per year on average and a maximum of 168 mudflows in 1930. To understand principle factors steering the variability of mudflow occurrences, synoptic scale circulation weather types (CWT) over Central Asia and Uzbekistan are investigated. The majority of mudflows (22%) occur during the advection of westerly airflow when moist air from Central and Southern Europe reaches Uzbekistan. This objectively classified synoptic situation can be related to one of the 15 primary synoptic circulation types over the Central Asia and Uzbekistan which were subjectively derived by Bugayev and Giorgio in 1930-40s (Bugayev et al., 1957), thus confirming the validity of this approach. By means of the CWT approach, we further analyse that on mudflow-days the frequencies of cyclonic, westerly, south-westerly and north-westerly stream flows are increased in comparison to the climatological frequency of occurrence of these circulation weather types. Details of the necessary and

Hospital surveillance of rotavirus infection and nosocomial transmission of rotavirus disease among children in Guinea-Bissau.

PubMed

Rodrigues, Amaélia; de Carvalho, Melo; Monteiro, Serifo; Mikkelsen, Carsten Sauer; Aaby, Peter; Molbak, Kåre; Fischer, Thea Kølsen

2007-03-01

Vaccination against rotavirus is protective against severe disease. Surveillance of rotavirus infection in developing countries might direct vaccination policy more efficiently. We implemented WHO's generic protocols for hospital-and community-based surveillance of rotavirus gastroenteritis. From April 2001 to May 2002, and from January 2003 to June 2003, we conducted hospital surveillance for rotavirus infection at the only pediatric ward in the capital of Guinea-Bissau. Children less than 5 years of age admitted with diarrhea or developing diarrhea during hospitalization were enrolled in the study. Rotavirus infection was detected in the feces samples using an ELISA assay. Rectal swabs were also obtained and its use was validated against stool specimen. During the surveillance period, 161 cases of rotavirus infection were registered. During the season, rotavirus accounted for 35% of all hospitalized diarrhea cases. The rate of nosocomial disease was 1.6 per 1000 child-days (95% confidence interval [CI] = 1.02-2.51) with high rates for children aged 12 to 23 months of age (rate: 3.09; 95% CI = 1.47-6.48). Most of the rotavirus cases (93%) were in children less than 2 years of age and only 10 children aged less than 3 months were infected. Fever (risk ratio (RR) 1.56; 95% CI = 1.16-2.10) and vomiting (RR 1.38; 95% CI = 1.11-1.73) were more common in patients with rotavirus than in patients with nonrotavirus diarrhea. The case-fatality was 8%. Results from stool samples and rectal swabs were concordant in 96% of the pairs. Rectal swabs increased the detection of rotavirus cases by 6% and deaths by 33% over stool sample results. Rotavirus infections were confined to a 4-month period each year. It is an important cause of childhood diarrhea with high case-fatality ratio in Guinea-Bissau. The use of rectal swab appeared to increase the detection rate of rotavirus infection and the case-fatality rate. The high rate of nosocomial infections in hospitalized children

Surveillance of hospital-acquired infections: a model for settings with resource constraints.

PubMed

Brusaferro, Silvio; Regattin, Laura; Faruzzo, Alda; Grasso, Adriana; Basile, Marco; Calligaris, Laura; Scudeller, Luigia; Viale, Pierluigi

2006-08-01

Surveillance activities have been considered of paramount importance for effective infection control programs in health care organizations. Our objective was to design a capture system able to assure surveillance of hospital-acquired infections (HAI) in acute hospitals with few resources devoted to infection control. We performed 4 biweekly repeated prevalence studies to identify major HAI (urinary tract infections, surgical site infections, lower respiratory tract infection, bloodstream infections) as defined by the Centers for Disease Control and Prevention (CDC) criteria in 3 large hospitals in northeastern Italy (6 internal medicine departments, 5 general surgery departments, 3 intensive care units, and 1 bone marrow transplant unit). One thousand five hundred fifty-four patients were screened (63.9% in medical wards, 27.5% in surgical wards, and 8.5% in intensive care units and bone transplant unit). The overall prevalence of infection was 4.9% (77/1,554); 4.5% (70/1,554) of patients were infected. A capture system based on the presence of fever >or=38 degrees C, antibiotic use, and presence of devices guarantees 100% sensitivity in detecting HAI but requires an assessment of 62% of the population. Using the presence of fever and devices as criteria guarantees a sensitivity of 98%, requiring an assessment of 41.4% of patients, whereas presence of fever and antibiotic use has the same sensitivity but requires an assessment of 50% of patients. Using nursing records, physician records, and direct patient examination as sources of documentation guarantees that all necessary data are collected while requiring a mean of 4 minutes and 42 seconds per patient (standard deviation, 1 minute and 30 seconds). A capture system based on biweekly repeated prevalence studies that select patients for the presence of fever, antibiotics, and medical devices ensures the detection of all HAI in a resource-limited environment.

The establishment of a statewide surveillance program for hospital-acquired infections in large Victorian public hospitals: a report from the VICNISS Coordinating Centre.

PubMed

Russo, Philip L; Bull, Ann; Bennett, Noleen; Boardman, Claire; Burrell, Simon; Motley, Jane; Berry, Kylie; Friedman, N Deborah; Richards, Michael

2006-09-01

A 1998 survey of acute Victorian public hospitals (VPH) revealed that surveillance of hospital-acquired infections (HAI) was underdeveloped, definitions and methodology varied considerably, and results disseminated inconsistently. The survey identified the need for an effective surveillance system for HAI. To develop and support a standardized surveillance program for HAIs in large acute VPH and to provide risk-adjusted, procedure-specific, HAI rates. In 2002, the independent Victorian Nosocomial Infection Surveillance System (VICNISS) Coordinating Centre (VCC) was established to develop and support the standardized surveillance program. A multidisciplinary team was recruited. A communication strategy, surveillance manual, user groups, and Web site were developed. Formal education sessions were provided to participating infection control nurse consultants (ICCs). Surveillance activities were based on the US Centers for Diseases Control and Prevention's National Nosocomial Infection Surveillance System (NNIS) surgical site infection and intensive care unit (ICU) components. NNIS methods were modified to suit local needs. Data collection was paper based or through existing hospital software. An advisory committee of key stakeholders met every second month. The surveillance program was rolled out over 12 months to all 28 large adult VPH. Data on over 20,000 surgical procedures performed at participating sites between November 11, 2002, and December 31, 2004, were submitted. Thirteen hospitals contributed to the ICU surveillance activities. Following aggregation and analysis by the VCC, hospital- and state-level results were posted on the Web page for hospitals to review. A standardized approach for surveillance of HAI was established in a short time frame in over 28 VPH. VICNISS is a tool that will continue to provide participating hospitals with a basis for continuous quality improvement.

Surveillance and Epidemiology of Drug Resistant Infections Consortium (SEDRIC): Supporting the transition from strategy to action

PubMed Central

Fukuda, Keiji; Limmathurotsakul, Direk; Okeke, Iruka N.; Shetty, Nandini; van Doorn, Rogier; Feasey, Nicholas A.; Chiara, Francesca; Zoubiane, Ghada; Jinks, Tim; Parkhill, Julian; Patel, Jean; Reid, Stuart W.J.; Holmes, Alison H.; Peacock, Sharon J.

2018-01-01

In recognition of the central importance of surveillance and epidemiology in the control of antimicrobial resistance and the need to strengthen surveillance at all levels, Wellcome has brought together a new international expert group SEDRIC (Surveillance and Epidemiology of Drug Resistant Infections Consortium). SEDRIC aims to advance and transform the ways of tracking, sharing and analysing rates of infection and drug resistance, burden of disease, information on antibiotic use, opportunities for preventative measures such as vaccines, and contamination of the environment. SEDRIC will strengthen the availability of information needed to monitor and track risks, including an evaluation of access to, and utility of data generated by pharma and research activities, and will support the translation of surveillance data into interventions, changes in policy and more effective practices. Ways of working will include the provision of independent scientific analysis, advocacy and expert advice to groups, such as the Wellcome Drug Resistant Infection Priority Programme. A priority for SEDRIC’s first Working Group is to review mechanisms to strengthen the generation, collection, collation and dissemination of high quality data, together with the need for creativity in the use of existing data and proxy measures, and linking to existing in-country networking infrastructure. SEDRIC will also promote the translation of technological innovations into public health solutions. PMID:29904730

Use of Bibliometric Analysis to Assess the Scientific Productivity and Impact of the Global Emerging Infections Surveillance and Response System Program, 2006-2012.

PubMed

Reaves, Erik J; Valle, Ruben; Chandrasekera, Ruvani M; Soto, Giselle; Burke, Ronald L; Cummings, James F; Bausch, Daniel G; Kasper, Matthew R

2017-05-01

Scientific publication in academic literature is a key venue in which the U.S. Department of Defense's Global Emerging Infections Surveillance and Response System (GEIS) program disseminates infectious disease surveillance data. Bibliometric analyses are tools to evaluate scientific productivity and impact of published research, yet are not routinely used for disease surveillance. Our objective was to incorporate bibliometric indicators to measure scientific productivity and impact of GEIS-funded infectious disease surveillance, and assess their utility in the management of the GEIS surveillance program. Metrics on GEIS program scientific publications, project funding, and countries of collaborating institutions from project years 2006 to 2012 were abstracted from annual reports and program databases and organized by the six surveillance priority focus areas: respiratory infections, gastrointestinal infections, febrile and vector-borne infections, antimicrobial resistance, sexually transmitted infections, and capacity building and outbreak response. Scientific productivity was defined as the number of scientific publications in peer-reviewed literature derived from GEIS-funded projects. Impact was defined as the number of citations of a GEIS-funded publication by other peer-reviewed publications, and the Thomson Reuters 2-year journal impact factor. Indicators were retrieved from the Web of Science and Journal Citation Report. To determine the global network of international collaborations between GEIS partners, countries were organized by the locations of collaborating institutions. Between 2006 and 2012, GEIS distributed approximately US $330 million to support 921 total projects. On average, GEIS funded 132 projects (range 96-160) with $47 million (range $43 million-$53 million), annually. The predominant surveillance focus areas were respiratory infections with 317 (34.4%) projects and $225 million, and febrile and vector-borne infections with 274 (29

Surveillance of congenital rubella and rubella infections in pregnancy in EU/EEA countries, 2012: Current status and future perspective to monitor elimination.

PubMed

Giambi, C; Montaño-Remacha, C; Celentano, L Pastore; Derrough, T

2015-09-11

Rubella elimination and congenital rubella syndrome (CRS) prevention are targets for achievement by 2015 in the WHO-EURO Region. This paper describes the existing surveillance systems for CRS and rubella in pregnancy in order to critically interpret the findings in relation to the 2012 WHO-EURO surveillance guidelines. In 2012 we conducted a survey to collect information on surveillance of CRS and rubella in pregnancy in 29 EU/EEA countries. Questionnaires explored the characteristics of the surveillance systems, case definition, epidemiological investigation and follow-up of cases, reference laboratories and types of tests performed. Twenty-eight countries had surveillance systems for CRS, mostly nationwide, mandatory, passive and case-based; 23 collected information on the origin of the infection; 11 reported asymptomatic infections; 6 required zero-reporting. Case definitions varied among countries, although 24 used the EU definition. Laboratories reported cases in 18 countries. Twenty countries collected information on pregnancy within the rubella surveillance system and 5 had specific surveillance for rubella in pregnancy. Two countries did not monitor outcomes of suspected infections in pregnancy; infants with CRS were monitored in all the remaining countries; asymptomatic infected infants in 15; stillbirths and fetal deaths in 13; therapeutic and spontaneous abortions in 8 and 7. Twenty-seven countries had a national reference laboratory for CRS and rubella in pregnancy; genotyping was performed in 15. The current surveillance systems allow adequate CRS monitoring in EU. Further efforts are needed to improve their quality, including uniform case definitions, collection of information on the origin of infection, and promotion of reporting from laboratories. Follow-up of pregnant women with suspected infection should be strengthened because it is an entry point for CRS, including detection of fetal deaths, stillbirths and abortions. Laboratory capacity for

The role of infection and sepsis in the Brazilian Network for Surveillance of Severe Maternal Morbidity.

PubMed

Pfitscher, L C; Cecatti, J G; Haddad, S M; Parpinelli, M A; Souza, J P; Quintana, S M; Surita, F G; Costa, M L

2016-02-01

To identify the burden of severe infection within the Brazilian Network for Surveillance of Severe Maternal Morbidity and factors associated with worse maternal outcomes. This was a multicentre cross-sectional study involving 27 referral maternity hospitals in Brazil. WHO's standardised criteria for potentially life-threatening conditions and maternal near miss were used to identify cases through prospective surveillance and the main cause of morbidity was identified as infection or other causes (hypertension, haemorrhage or clinical/surgical). Complications due to infection were compared to complications due to the remaining causes of morbidity. Factors associated with a severe maternal outcome were assessed for the cases of infection. A total of 502 (5.3%) cases of maternal morbidity were associated with severe infection vs. 9053 cases (94.7%) with other causes. Considering increased severity of cases, infection was responsible for one-fourth of all maternal near miss (23.6%) and nearly half (46.4%) of maternal deaths, with a maternal near miss to maternal death ratio three times (2.8:1) that of cases without infection (7.8:1) and a high mortality index (26.3%). Within cases of infection, substandard care was present in over one half of the severe maternal outcome cases. Factors independently associated with worse maternal outcomes were HIV/AIDS, hysterectomy, prolonged hospitalisation, intensive care admission and delays in medical care. Infection is an alarming cause of maternal morbidity and mortality and timely diagnosis and adequate management are key to improving outcomes during pregnancy. Delays should be addressed, risk factors identified, and specific protocols of surveillance and care developed for use during pregnancy. © 2015 John Wiley & Sons Ltd.

Documentation for Preservation: Methodology and a GIS Database of Three World Heritage Cities in Uzbekistan

NASA Astrophysics Data System (ADS)

Vileikis, O.; Escalante Carrillo, E.; Allayarov, S.; Feyzulayev, A.

2017-08-01

The historic cities of Uzbekistan are an irreplaceable legacy of the Silk Roads. Currently, Uzbekistan counts with four UNESCO World Heritage Properties, with hundreds of historic monuments and traditional historic houses. However, lack of documentation, systematic monitoring and a digital database, of the historic buildings and dwellings within the historic centers, are threatening the World Heritage properties and delaying the development of a proper management mechanism for the preservation of the heritage and an interwoven city urban development. Unlike the monuments, the traditional historic houses are being demolished without any enforced legal protection, leaving no documentation to understand the city history and its urban fabric as well of way of life, traditions and customs over the past centuries. To fill out this gap, from 2008 to 2015, the Principal Department for Preservation and Utilization of Cultural Objects of the Ministry of Culture and Sports of Uzbekistan with support from the UNESCO Office in Tashkent, and in collaboration with several international and local universities and institutions, carried out a survey of the Historic Centre of Bukhara, Itchan Kala and Samarkand Crossroad of Cultures. The collaborative work along these years have helped to consolidate a methodology and to integrate a GIS database that is currently contributing to the understanding of the outstanding heritage values of these cities as well as to develop preservation and management strategies with a solid base of heritage documentation.

Epidemiology, surveillance, and prevention of bloodstream infections in hemodialysis patients.

PubMed

Patel, Priti R; Kallen, Alexander J; Arduino, Matthew J

2010-09-01

Infections cause significant morbidity and mortality in patients undergoing hemodialysis. Bloodstream infections (BSIs) are particularly problematic, accounting for a substantial number of hospitalizations in these patients. Hospitalizations for BSI and other vascular access infections appear to have increased dramatically in hemodialysis patients since 1993. These infections frequently are related to central venous catheter (CVC) use for dialysis access. Regional initiatives that have shown successful decreases in catheter-related BSIs in hospitalized patients have generated interest in replicating this success in outpatient hemodialysis populations. Several interventions have been effective in preventing BSIs in the hemodialysis setting. Avoiding the use of CVCs in favor of access types with lower associated BSI risk is among the most important. When CVCs are used, adherence to evidence-based catheter insertion and maintenance practices can positively influence BSI rates. In addition, facility-level surveillance to detect BSIs and stimulate examination of vascular access use and care practices is essential to a comprehensive approach to prevention. This article describes the current epidemiology of BSIs in hemodialysis patients and effective prevention strategies to decrease the incidence of these devastating infections.

Efficient surveillance for healthcare-associated infections spreading between hospitals

PubMed Central

Ciccolini, Mariano; Donker, Tjibbe; Grundmann, Hajo; Bonten, Marc J. M.; Woolhouse, Mark E. J.

2014-01-01

Early detection of new or novel variants of nosocomial pathogens is a public health priority. We show that, for healthcare-associated infections that spread between hospitals as a result of patient movements, it is possible to design an effective surveillance system based on a relatively small number of sentinel hospitals. We apply recently developed mathematical models to patient admission data from the national healthcare systems of England and The Netherlands. Relatively short detection times are achieved once 10–20% hospitals are recruited as sentinels and only modest reductions are seen as more hospitals are recruited thereafter. Using a heuristic optimization approach to sentinel selection, the same expected time to detection can be achieved by recruiting approximately half as many hospitals. Our study provides a robust evidence base to underpin the design of an efficient sentinel hospital surveillance system for novel nosocomial pathogens, delivering early detection times for reduced expenditure and effort. PMID:24469791

Malaria and other vector-borne infection surveillance in the U.S. Department of Defense Armed Forces Health Surveillance Center-Global Emerging Infections Surveillance program: review of 2009 accomplishments.

PubMed

Fukuda, Mark M; Klein, Terry A; Kochel, Tadeusz; Quandelacy, Talia M; Smith, Bryan L; Villinski, Jeff; Bethell, Delia; Tyner, Stuart; Se, Youry; Lon, Chanthap; Saunders, David; Johnson, Jacob; Wagar, Eric; Walsh, Douglas; Kasper, Matthew; Sanchez, Jose L; Witt, Clara J; Cheng, Qin; Waters, Norman; Shrestha, Sanjaya K; Pavlin, Julie A; Lescano, Andres G; Graf, Paul C F; Richardson, Jason H; Durand, Salomon; Rogers, William O; Blazes, David L; Russell, Kevin L; Akala, Hoseah; Gaydos, Joel C; DeFraites, Robert F; Gosi, Panita; Timmermans, Ans; Yasuda, Chad; Brice, Gary; Eyase, Fred; Kronmann, Karl; Sebeny, Peter; Gibbons, Robert; Jarman, Richard; Waitumbi, John; Schnabel, David; Richards, Allen; Shanks, Dennis

2011-03-04

Vector-borne infections (VBI) are defined as infectious diseases transmitted by the bite or mechanical transfer of arthropod vectors. They constitute a significant proportion of the global infectious disease burden. United States (U.S.) Department of Defense (DoD) personnel are especially vulnerable to VBIs due to occupational contact with arthropod vectors, immunological naiveté to previously unencountered pathogens, and limited diagnostic and treatment options available in the austere and unstable environments sometimes associated with military operations. In addition to the risk uniquely encountered by military populations, other factors have driven the worldwide emergence of VBIs. Unprecedented levels of global travel, tourism and trade, and blurred lines of demarcation between zoonotic VBI reservoirs and human populations increase vector exposure. Urban growth in previously undeveloped regions and perturbations in global weather patterns also contribute to the rise of VBIs. The Armed Forces Health Surveillance Center-Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) and its partners at DoD overseas laboratories form a network to better characterize the nature, emergence and growth of VBIs globally. In 2009 the network tested 19,730 specimens from 25 sites for Plasmodium species and malaria drug resistance phenotypes and nearly another 10,000 samples to determine the etiologies of non-Plasmodium species VBIs from regions spanning from Oceania to Africa, South America, and northeast, south and Southeast Asia. This review describes recent VBI-related epidemiological studies conducted by AFHSC-GEIS partner laboratories within the OCONUS DoD laboratory network emphasizing their impact on human populations.

Malaria and other vector-borne infection surveillance in the U.S. Department of Defense Armed Forces Health Surveillance Center-Global Emerging Infections Surveillance program: review of 2009 accomplishments

PubMed Central

2011-01-01

Vector-borne infections (VBI) are defined as infectious diseases transmitted by the bite or mechanical transfer of arthropod vectors. They constitute a significant proportion of the global infectious disease burden. United States (U.S.) Department of Defense (DoD) personnel are especially vulnerable to VBIs due to occupational contact with arthropod vectors, immunological naiveté to previously unencountered pathogens, and limited diagnostic and treatment options available in the austere and unstable environments sometimes associated with military operations. In addition to the risk uniquely encountered by military populations, other factors have driven the worldwide emergence of VBIs. Unprecedented levels of global travel, tourism and trade, and blurred lines of demarcation between zoonotic VBI reservoirs and human populations increase vector exposure. Urban growth in previously undeveloped regions and perturbations in global weather patterns also contribute to the rise of VBIs. The Armed Forces Health Surveillance Center-Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) and its partners at DoD overseas laboratories form a network to better characterize the nature, emergence and growth of VBIs globally. In 2009 the network tested 19,730 specimens from 25 sites for Plasmodium species and malaria drug resistance phenotypes and nearly another 10,000 samples to determine the etiologies of non-Plasmodium species VBIs from regions spanning from Oceania to Africa, South America, and northeast, south and Southeast Asia. This review describes recent VBI-related epidemiological studies conducted by AFHSC-GEIS partner laboratories within the OCONUS DoD laboratory network emphasizing their impact on human populations. PMID:21388569

Population-based surveillance of neonatal herpes simplex virus infection in Australia, 1997-2011.

PubMed

Jones, Cheryl A; Raynes-Greenow, Camille; Isaacs, David

2014-08-15

Neonatal herpes simplex virus (HSV) infection is uncommon, but mortality after disseminated disease and morbidity after encephalitis are high. For the last decade, increased dose and duration of acyclovir has been advised to prevent disease progression and recurrence. We sought to determine prospectively the epidemiologic, clinical, and secular trends of this condition in Australia. This was prospective national active surveillance for neonatal HSV disease through the Australian Paediatric Surveillance Unit from 1997 to 2011. Case notification triggered a questionnaire requesting de-identified data from the pediatric clinician. We identified 131 confirmed cases of neonatal HSV disease in 15 years from 261 notifications (95% response). The reported incidence (3.27 cases per 100 000 live births overall; 95% confidence interval [CI], 2.73-3.86) was stable. Overall mortality was 18.8% (95% CI, 12.1-25.5); the mortality rate was significantly lower in the latter part of the study period, 2005-2011, compared with 1997-2004 (P = .04). There were significantly more young mothers (<20 years of age) compared with Australian birth record data (18.5% vs 4.8%; P < .001). HSV-1 infection was more common than HSV-2 (62.7% vs 37.3%; P < .001), and the rate of HSV-1 infections increased significantly over the surveillance period (P < .05). From 2002, most infants received high-dose acyclovir. The time from symptom onset to initiation of therapy in survivors did not change over time. Mortality from neonatal HSV infection has fallen but remains high. HSV-1 is the major serotype causing neonatal disease in Australia. Young mothers represent an important target group for prevention. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Hospital adoption of automated surveillance technology and the implementation of infection prevention and control programs.

PubMed

Halpin, Helen; Shortell, Stephen M; Milstein, Arnold; Vanneman, Megan

2011-05-01

This research analyzes the relationship between hospital use of automated surveillance technology (AST) for identification and control of hospital-acquired infections (HAI) and implementation of evidence-based infection control practices. Our hypothesis is that hospitals that use AST have made more progress implementing infection control practices than hospitals that rely on manual surveillance. A survey of all acute general care hospitals in California was conducted from October 2008 through January 2009. A structured computer-assisted telephone interview was conducted with the quality director of each hospital. The final sample includes 241 general acute care hospitals (response rate, 83%). Approximately one third (32.4%) of California's hospitals use AST for monitoring HAI. Adoption of AST is statistically significant and positively associated with the depth of implementation of evidence-based practices for methicillin-resistant Staphylococcus aureus and ventilator-associated pneumonia and adoption of contact precautions and surgical care infection practices. Use of AST is also statistically significantly associated with the breadth of hospital implementation of evidence-based practices across all 5 targeted HAI. Our findings suggest that hospitals using AST can achieve greater depth and breadth in implementing evidenced-based infection control practices. Copyright © 2011 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

Sustained live poultry market surveillance contributes to early warnings for human infection with avian influenza viruses.

PubMed

Fang, Shisong; Bai, Tian; Yang, Lei; Wang, Xin; Peng, Bo; Liu, Hui; Geng, Yijie; Zhang, Renli; Ma, Hanwu; Zhu, Wenfei; Wang, Dayan; Cheng, Jinquan; Shu, Yuelong

2016-08-03

Sporadic human infections with the highly pathogenic avian influenza (HPAI) A (H5N6) virus have been reported in different provinces in China since April 2014. From June 2015 to January 2016, routine live poultry market (LPM) surveillance was conducted in Shenzhen, Guangdong Province. H5N6 viruses were not detected until November 2015. The H5N6 virus-positive rate increased markedly beginning in December 2015, and viruses were detected in LPMs in all districts of the city. Coincidently, two human cases with histories of poultry exposure developed symptoms and were diagnosed as H5N6-positive in Shenzhen during late December 2015 and early January 2016. Similar viruses were identified in environmental samples collected in the LPMs and the patients. In contrast to previously reported H5N6 viruses, viruses with six internal genes derived from the H9N2 or H7N9 viruses were detected in the present study. The increased H5N6 virus-positive rate in the LPMs and the subsequent human infections demonstrated that sustained LPM surveillance for avian influenza viruses provides an early warning for human infections. Interventions, such as LPM closures, should be immediately implemented to reduce the risk of human infection with the H5N6 virus when the virus is widely detected during LPM surveillance.

Active Surveillance Cultures and Decolonization to Reduce Staphylococcus aureus Infections in the Neonatal Intensive Care Unit.

PubMed

Popoola, Victor O; Colantuoni, Elizabeth; Suwantarat, Nuntra; Pierce, Rebecca; Carroll, Karen C; Aucott, Susan W; Milstone, Aaron M

2016-04-01

Staphylococcus aureus is a common cause of healthcare-associated infections in neonates. To examine the impact of methicillin-susceptible S. aureus (MSSA) decolonization on the incidence of MSSA infection and to measure the prevalence of mupirocin resistance. We retrospectively identified neonates admitted to a tertiary care neonatal intensive care unit (NICU) from April 1, 2011, through September 30, 2014. We compared rates of MSSA-positive cultures and infections before and after implementation of an active surveillance culture and decolonization intervention for MSSA-colonized neonates. We used 2 measurements to identify the primary outcome, NICU-attributable MSSA: (1) any culture sent during routine clinical care that grew MSSA and (2) any culture that grew MSSA and met criteria of the National Healthcare Safety Network's healthcare-associated infection surveillance definitions. S. aureus isolates were tested for mupirocin susceptibility. We estimated incidence rate ratios using interrupted time-series models. Before and after the intervention, 1,523 neonates (29,220 patient-days) and 1,195 neonates (22,045 patient-days) were admitted to the NICU, respectively. There was an immediate reduction in the mean quarterly incidence rate of NICU-attributable MSSA-positive clinical cultures of 64% (incidence rate ratio, 0.36 [95% CI, 0.19-0.70]) after implementation of the intervention, and MSSA-positive culture rates continued to decrease by 21% per quarter (incidence rate ratio, 0.79 [95% CI, 0.74-0.84]). MSSA infections also decreased by 73% immediately following the intervention implementation (incidence rate ratio, 0.27 [95% CI, 0.10-0.79]). No mupirocin resistance was detected. Active surveillance cultures and decolonization may be effective in decreasing S. aureus infections in NICUs.

Surveillance of bloodstream infections in pediatric cancer centers - what have we learned and how do we move on?

PubMed

Simon, Arne; Furtwängler, Rhoikos; Graf, Norbert; Laws, Hans Jürgen; Voigt, Sebastian; Piening, Brar; Geffers, Christine; Agyeman, Philipp; Ammann, Roland A

2016-01-01

Pediatric patients receiving conventional chemotherapy for malignant disease face an increased risk of bloodstream infection (BSI). Since BSI may represent an acute life-threatening event in patients with profound immunosuppression, and show further negative impact on quality of life and anticancer treatment, the prevention of BSI is of paramount importance to improve and guarantee patients' safety during intensive treatment. The great majority of all pediatric cancer patients (about 85%) have a long-term central venous access catheter in use (type Broviac or Port; CVAD). Referring to the current surveillance definitions a significant proportion of all BSI in pediatric patients with febrile neutropenia is categorized as CVAD-associated BSI. This state of the art review summarizes the epidemiology and the distinct pathogen profile of BSI in pediatric cancer patients from the perspective of infection surveillance. Problems in executing the current surveillance definition in this patient population are discussed and a new concept for the surveillance of BSI in pediatric cancer patients is outlined.

[Surveillance of healthcare associated infections, bacterial resistance and antibiotic consumption in high-complexity hospitals in Colombia, 2011].

PubMed

Villalobos, Andrea Patricia; Barrero, Liliana Isabel; Rivera, Sandra Milena; Ovalle, María Victoria; Valera, Danik

2014-04-01

Preventing healthcare associated infections, especially for resistant microorganisms, is a priority. In Colombia, the surveillance of such events was started through a national pilot study. To describe the epidemiology of device-associated infections, bacterial resistance and antibiotic consumption patterns in institutions with intensive care units (ICU), 2011. Descriptive observational study in 10 health institutions from three Colombian provinces: Antioquia, Valle del Cauca, and Bogotá. Surveillance protocols were designed and implemented by trained health professionals in each hospital. A web tool was designed for data reporting and analysis. Infection rates, device-use percentages and antibiotics defined daily dose (DDD) were calculated. Bacterial resistance phenotypes and profiles were reported and analyzed using Whonet 5.6. The most common event was bloodstream infection (rate > 4.8/1000 catheter-days) followed by ventilator-associated pneumonia (VAP) and catheter-related urinary tract infection, showing a wide variability among institutions. A high consumption of meropenem in the ICU (DDD 22.5/100 beds-day) was observed, as well as a high carbapenem resistance (> 11.6%) and a high frequency of third generation cephalosporins resistance (> 25.6%) in Enterobacteriaceae in ICUs and hospitalization wards. The percentage of methicillin-resistant Staphylococcus aureus was higher in hospitalization wards (34.3%). This is the first experience in measuring these events in Colombia. It is necessary to implement a national surveillance system aimed at guiding governmental and institutional actions oriented to infection prevention and control, to resistance management and to the promotion of antibiotics rational use, along with a follow-up and monitoring process.

Syndromic surveillance for evaluating the occurrence of healthcare-associated infections in equine hospitals.

PubMed

Ruple-Czerniak, A A; Aceto, H W; Bender, J B; Paradis, M R; Shaw, S P; Van Metre, D C; Weese, J S; Wilson, D A; Wilson, J; Morley, P S

2014-07-01

Methods that can be used to estimate rates of healthcare-associated infections and other nosocomial events have not been well established for use in equine hospitals. Traditional laboratory-based surveillance is expensive and cannot be applied in all of these settings. To evaluate the use of a syndromic surveillance system for estimating rates of occurrence of healthcare-associated infections among hospitalised equine cases. Multicentre, prospective longitudinal study. This study included weaned equids (n = 297) that were admitted for gastrointestinal disorders at one of 5 participating veterinary referral hospitals during a 12-week period in 2006. A survey form was completed by the primary clinician to summarise basic case information, procedures and treatments the horse received, and whether one or more of 7 predefined nosocomial syndromes were recognised at any point during hospitalisation. Adjusted rates of nosocomial events were estimated using Poisson regression. Risk factors associated with the risk of developing a nosocomial event were analysed using multivariable logistic regression. Among the study population, 95 nosocomial events were reported to have occurred in 65 horses. Controlling for differences among hospitals, 19.7% (95% confidence interval, 14.5-26.7) of the study population was reported to have had at least one nosocomial event recognised during hospitalisation. The most commonly reported nosocomial syndromes that were unrelated to the reason for hospitalisation were surgical site inflammation and i.v. catheter site inflammation. Syndromic surveillance systems can be standardised successfully for use across multiple hospitals without interfering with established organisational structures, in order to provide useful estimates of rates related to healthcare-associated infections. © 2013 EVJ Ltd.

Salmonella infections associated with international travel: a Foodborne Diseases Active Surveillance Network (FoodNet) study.

PubMed

Johnson, Laura R; Gould, L Hannah; Dunn, John R; Berkelman, Ruth; Mahon, Barbara E

2011-09-01

Salmonella species cause an estimated 1.2 million infections per year in the United States, making it one of the most commonly reported enteric pathogens. In addition, Salmonella is an important cause of travel-associated diarrhea and enteric fever, a systemic illness commonly associated with Salmonella serotypes Typhi and Paratyphi A. We reviewed cases of Salmonella infection reported to the Centers for Disease Control and Prevention's (CDC) Foodborne Diseases Active Surveillance Network (FoodNet), a sentinel surveillance network, from 2004 to 2008. We compared travelers with Salmonella infection to nontravelers with Salmonella infection with respect to demographics, clinical characteristics, and serotypes. Among 23,712 case-patients with known travel status, 11% had traveled internationally in the 7 days before illness. Travelers with Salmonella infection tended to be older (median age, 30 years) than nontravelers (median age, 24 years; p<0.0001), but were similar with respect to gender. The most common destinations reported were Mexico (38% of travel-associated infections), India (9%), Jamaica (7%), the Dominican Republic (4%), China (3%), and the Bahamas (2%). The proportions of travelers with Salmonella infection hospitalized and with invasive disease were inversely related to the income level of the destination (p<0.0001). The most commonly reported serotypes, regardless of travel status, were Enteritidis (19% of cases), Typhimurium (14%), Newport (9%), and Javiana (5%). Among infections caused by these four serotypes, 22%, 6%, 5%, and 4%, respectively, were associated with travel. A high index of clinical suspicion for Salmonella infection is appropriate when evaluating recent travelers, especially those who visited Africa, Asia, or Latin America.

Using electronic medical records to increase the efficiency of catheter-associated urinary tract infection surveillance for National Health and Safety Network reporting.

PubMed

Shepard, John; Hadhazy, Eric; Frederick, John; Nicol, Spencer; Gade, Padmaja; Cardon, Andrew; Wilson, Jorge; Vetteth, Yohan; Madison, Sasha

2014-03-01

Streamlining health care-associated infection surveillance is essential for health care facilities owing to the continuing increases in reporting requirements. Stanford Hospital, a 583-bed adult tertiary care center, used their electronic medical record (EMR) to develop an electronic algorithm to reduce the time required to conduct catheter-associated urinary tract infection (CAUTI) surveillance in adults. The algorithm provides inclusion and exclusion criteria, using the National Healthcare Safety Network definitions, for patients with a CAUTI. The algorithm was validated by trained infection preventionists through complete chart review for a random sample of cultures collected during the study period, September 1, 2012, to February 28, 2013. During the study period, a total of 6,379 positive urine cultures were identified. The Stanford Hospital electronic CAUTI algorithm identified 6,101 of these positive cultures (95.64%) as not a CAUTI, 191 (2.99%) as a possible CAUTI requiring further validation, and 87 (1.36%) as a definite CAUTI. Overall, use of the algorithm reduced CAUTI surveillance requirements at Stanford Hospital by 97.01%. The electronic algorithm proved effective in increasing the efficiency of CAUTI surveillance. The data suggest that CAUTI surveillance using the National Healthcare Safety Network definitions can be fully automated. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

[Surveillance of surgical-site infections: results of the INCISO 1998 Network].

PubMed

Golliot, F; Astagneau, P; Brücker, G

1999-01-01

Surveillance of Surgical-Site Infection (SSI) in general and visceral surgical departments. Prospective cohort study. Inter-regional Co-ordinating Center for Nosocomial Infection Control (C.CLIN Paris-Nord). Regions of Ile de France, Haute Normandie, Nord-Pas de Calais and Picardie. From January 1 to April 1, 1998, each surgical department had included 200 consecutive operations. To diagnose SSI occurring after discharge, patients were followed during one month after surgery. SSI were defined according to standardized criteria. Overall, 16.506 surgeries were followed in 120 surgical units. The rate of postoperative SSI was 3.9% (95CI = [3.6%-4.2%]). The rate of SSI varied from 5.2% for digestive surgery to 0.9% for endocrine system, and 2.3% for cholecystectomy to 16.6% for peritonitis. According to the NNIS index, SSI rates increased from 2.2% for patients with a risk index of 0 to 26.7% for patients with a risk index of 3. The case fatality rate directly or indirectly attributable to SSI was 2.0% (95CI = [1.1%-3.5%]). The high incidence of SSI render crucial the implementation of SSI surveillance in surgery. Risk factors and type of surgical procedures are required to obtain standardized rates for comparisons between services.

"Water Is Life"--Farmer Rationales and Water Saving in Khorezm, Uzbekistan: A Lifeworld Analysis

ERIC Educational Resources Information Center

Oberkircher, Lisa; Hornidge, Anna-Katharina

2011-01-01

Khorezm Province is located in the Amu Darya lowlands of Uzbekistan, where unsustainable use of irrigation water has led to the Aral Sea crisis. This study deals with the question of how farmers in Khorezm perceive water and its management and how this facilitates or prevents water conservation, or "water saving," in irrigated…

Using Syndromic Surveillance to Investigate Tattoo-Related Skin Infections in New York City

PubMed Central

Kotzen, Mollie; Sell, Jessica; Mathes, Robert W.; Dentinger, Catherine; Lee, Lillian; Schiff, Corinne; Weiss, Don

2015-01-01

In response to two isolated cases of Mycobacterium chelonae infections in tattoo recipients where tap water was used to dilute ink, the New York City (NYC) Department of Health and Mental Hygiene conducted an investigation using Emergency Department (ED) syndromic surveillance to assess whether an outbreak was occuring. ED visits with chief complaints containing the key word “tattoo” from November 1, 2012 to March 18, 2013 were selected for study. NYC laboratories were also contacted and asked to report skin or soft tissue cultures in tattoo recipients that were positive for non-tuberculosis mycobacterial infection (NTM). Thirty-one TREDV were identified and 14 (45%) were interviewed to determine if a NTM was the cause for the visit. One ED visit met the case definition and was referred to a dermatologist. This individual was negative for NTM. No tattoo-associated NTM cases were reported by NYC laboratories. ED syndromic surveillance was utilized to investigate a non-reportable condition for which no other data source existed. The results were reassuring that an outbreak of NTM in tattoo recipients was not occurring. In response to concerns about potential NTM infections, the department sent a letter to all licensed tattoo artists advising them not to dilute tattoo ink with tap water. PMID:26076006

Diagnosed HIV Infection in Transgender Adults and Adolescents: Results from the National HIV Surveillance System, 2009-2014.

PubMed

Clark, Hollie; Babu, Aruna Surendera; Wiewel, Ellen Weiss; Opoku, Jenevieve; Crepaz, Nicole

2017-09-01

Publications on diagnosed HIV infection among transgender people have been limited to state- or local-level data. We analyzed data from the National HIV Surveillance System and present results from the first national-level analysis of transgender people with diagnosed HIV infection. From 2009 to 2014, HIV surveillance jurisdictions from 45 states plus the District of Columbia identified and reported at least one case of newly diagnosed HIV infection for transgender people; jurisdictions from 5 states reported no cases for transgender people. Of 2351 transgender people with newly diagnosed HIV infection during 2009-2014, 84.0% were transgender women (male-to-female), 15.4% were transgender men (female-to-male), and 0.7% were additional gender identity (e.g., gender queer, bi-gender). Over half of both transgender women (50.8%; 1002/1974) and men (58.4%; 211/361) with newly diagnosed HIV infection were non-Hispanic black/African American. Improvements in data collection methods and quality are needed to gain a better understanding of HIV burden among transgender people.

Designing and Implementing the First Environmental and Science Journalism Course for an Uzbekistan Journalism School

ERIC Educational Resources Information Center

Freedman, Eric

2004-01-01

Uzbekistan faces severe ecological problems including the rapidly shrinking Aral Sea, desertification, residues of biochemical weapons, and environmentally related respiratory disease. Even so, the country's print and broadcast media do little in-depth or analytical reporting on environmental issues, nor are journalists trained to cover such…

Surveillance of bloodstream infections in pediatric cancer centers – what have we learned and how do we move on?

PubMed Central

Simon, Arne; Furtwängler, Rhoikos; Graf, Norbert; Laws, Hans Jürgen; Voigt, Sebastian; Piening, Brar; Geffers, Christine; Agyeman, Philipp; Ammann, Roland A.

2016-01-01

Pediatric patients receiving conventional chemotherapy for malignant disease face an increased risk of bloodstream infection (BSI). Since BSI may represent an acute life-threatening event in patients with profound immunosuppression, and show further negative impact on quality of life and anticancer treatment, the prevention of BSI is of paramount importance to improve and guarantee patients’ safety during intensive treatment. The great majority of all pediatric cancer patients (about 85%) have a long-term central venous access catheter in use (type Broviac or Port; CVAD). Referring to the current surveillance definitions a significant proportion of all BSI in pediatric patients with febrile neutropenia is categorized as CVAD-associated BSI. This state of the art review summarizes the epidemiology and the distinct pathogen profile of BSI in pediatric cancer patients from the perspective of infection surveillance. Problems in executing the current surveillance definition in this patient population are discussed and a new concept for the surveillance of BSI in pediatric cancer patients is outlined. PMID:27274442

Downward trends in surgical site and urinary tract infections after cesarean delivery in a French surveillance network, 1997-2003.

PubMed

Vincent, Agnès; Ayzac, Louis; Girard, Raphaële; Caillat-Vallet, Emmanuelle; Chapuis, Catherine; Depaix, Florence; Dumas, Anne-Marie; Gignoux, Chantal; Haond, Catherine; Lafarge-Leboucher, Joëlle; Launay, Carine; Tissot-Guerraz, Françoise; Fabry, Jacques

2008-03-01

To evaluate whether the adjusted rates of surgical site infection (SSI) and urinary tract infection (UTI) after cesarean delivery decrease in maternity units that perform active healthcare-associated infection surveillance. Trend analysis by means of multiple logistic regression. A total of 80 maternity units participating in the Mater Sud-Est surveillance network. A total of 37,074 cesarean deliveries were included in the surveillance from January 1, 1997, through December 31, 2003. We used a logistic regression model to estimate risk-adjusted post-cesarean delivery infection odds ratios. The variables included were the maternity units' annual rate of operative procedures, the level of dispensed neonatal care, the year of delivery, maternal risk factors, and the characteristics of cesarean delivery. The trend of risk-adjusted odds ratios for SSI and UTI during the study period was studied by linear regression. The crude rates of SSI and UTI after cesarean delivery were 1.5% (571 of 37,074 patients) and 1.8% (685 of 37,074 patients), respectively. During the study period, the decrease in SSI and UTI adjusted odds ratios was statistically significant (R=-0.823 [P=.023] and R=-0.906 [P=.005], respectively). Reductions of 48% in the SSI rate and 52% in the UTI rate were observed in the maternity units. These unbiased trends could be related to progress in preventive practices as a result of the increased dissemination of national standards and a collaborative surveillance with benchmarking of rates.

Accuracy of administrative data for surveillance of healthcare-associated infections: a systematic review

PubMed Central

van Mourik, Maaike S M; van Duijn, Pleun Joppe; Moons, Karel G M; Bonten, Marc J M; Lee, Grace M

2015-01-01

Objective Measuring the incidence of healthcare-associated infections (HAI) is of increasing importance in current healthcare delivery systems. Administrative data algorithms, including (combinations of) diagnosis codes, are commonly used to determine the occurrence of HAI, either to support within-hospital surveillance programmes or as free-standing quality indicators. We conducted a systematic review evaluating the diagnostic accuracy of administrative data for the detection of HAI. Methods Systematic search of Medline, Embase, CINAHL and Cochrane for relevant studies (1995–2013). Methodological quality assessment was performed using QUADAS-2 criteria; diagnostic accuracy estimates were stratified by HAI type and key study characteristics. Results 57 studies were included, the majority aiming to detect surgical site or bloodstream infections. Study designs were very diverse regarding the specification of their administrative data algorithm (code selections, follow-up) and definitions of HAI presence. One-third of studies had important methodological limitations including differential or incomplete HAI ascertainment or lack of blinding of assessors. Observed sensitivity and positive predictive values of administrative data algorithms for HAI detection were very heterogeneous and generally modest at best, both for within-hospital algorithms and for formal quality indicators; accuracy was particularly poor for the identification of device-associated HAI such as central line associated bloodstream infections. The large heterogeneity in study designs across the included studies precluded formal calculation of summary diagnostic accuracy estimates in most instances. Conclusions Administrative data had limited and highly variable accuracy for the detection of HAI, and their judicious use for internal surveillance efforts and external quality assessment is recommended. If hospitals and policymakers choose to rely on administrative data for HAI surveillance, continued

Emerging multidrug-resistant Candida duobushaemulonii infections in Panama hospitals: importance of laboratory surveillance and accurate identification.

PubMed

Ramos, Ruben; Caceres, Diego H; Perez, Marilyn; Garcia, Nicole; Castillo, Wendy; Santiago, Erika; Borace, Jovanna; Lockhart, Shawn R; Berkow, Elizabeth L; Hayer, Lizbeth; Espinosa-Bode, Andres; Moreno, Jose; Jackson, Brendan R; Moran, Jackeline; Chiller, Tom; de Villarreal, Gloriela; Sosa, Nestor; Vallabhaneni, Snigdha

2018-04-25

Candida duobushaemulonii , a yeast closely related to Candida auris, is thought to rarely cause infections, and is often misidentified. In October 2016, the Panamanian Ministry of Health implemented laboratory surveillance for C. auris Suspected C. auris isolates were forwarded to the national reference laboratory for identification by Matrix Assisted Laser Desorption Ionization-Time of Flight mass spectrometry and antifungal susceptibility testing. During November 2016-May 2017, 17 of 36 (47%) isolates suspected to be C. auris were identified as C. duobushaemulonii. These 17 isolates were obtained from 14 patients at six hospitals. Ten patients, including three children, had bloodstream infections, MICs for fluconazole, voriconazole, and amphotericin B were elevated. No resistance to echinocandins was observed. C. duobushaemulonii causes more invasive infections than previously appreciated, and poses a substantial problem given it is resistant to multiple antifungals. Expanded laboratory surveillance is an important step in the detection and control of such emerging pathogens. Copyright © 2018 American Society for Microbiology.

Is hospital information system relevant to detect surgical site infection? Findings from a prospective surveillance study in posterior instrumented spinal surgery.

PubMed

Boetto, J; Chan-Seng, E; Lonjon, G; Pech, J; Lotthé, A; Lonjon, N

2015-11-01

Spinal instrumentation has a high rate of surgical site infection (SSI), but results greatly vary depending on surveillance methodology, surgical procedures, or quality of follow-up. Our aim was to study true incidence of SSI in spinal surgery by significant data collection, and to compare it with the results obtained through the hospital information system. This work is a single center prospective cohort study that included all patients consecutively operated on for spinal instrumentation by posterior approach over a six-month period regardless the etiology. For all patients, a "high definition" prospective method of surveillance was performed by the infection control (IC) department during at least 12 months after surgery. Results were then compared with findings from automatic surveillance though the hospital information system (HIS). One hundred and fifty-four patients were included. We found no hardly difference between "high definition" and automatic surveillance through the HIS, even if HIS tended to under-estimate the infection rate: rate of surgical site infection was 2.60% and gross SSI incidence rate via the hospital information system was 1.95%. Smoking and alcohol consumption were significantly related to a SSI. Our SSI rates to reflect the true incidence of infectious complications in posterior instrumented adult spinal surgery in our hospital and these results were consistent with the lower levels of published infection rate. In-house surveillance by surgeons only is insufficiently sensitive. Further studies with more patients and a longer inclusion time are needed to conclude if SSI case detection through the HIS could be a relevant and effective alternative method. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

[Surveillance of schistosomiasis in national surveillance sites of Zhenjiang City, 2005-2010].

PubMed

Zhu, Xin-yun; Wu, Rong-feng; Shen, Xue-hui; Li, Ye-fang

2015-12-01

To master the changes of schistosomiasis epidemic situation in national surveillance sites of Zhenjiang City, Jiangsu Province. According to the scheme of the national schistosomiasis surveillance, the Shicheng Village of Yangzhong County and Sanzhou Village of Dantu District were selected as the national schistosomiasis surveillance sites, and from 2005 to 2010, the schistosomiasis morbidity and Oncomelania hupensis status were surveyed and the results were analyzed statistically. In 2010, in the Shicheng Village, the reduction rates of mean living snail density, infected snail density, area with infected snails, and positive blood tests in residents were 98.4%, 0, 0, 71.8% respectively, and in the Sanzhou Village, the reduction rates were 70.4%, 100%, 100% and 81.5%, respectively compared with those in 2005. No acute infections were found in the 2 villages during the period of 6 consecutive years. In the national surveillance sites of Zhenjiang City, the schistosomiasis morbidity has been effectively controlled. However, the areas with snails change little. Therefore, the comprehensive management of snail environment in the marshland should be strengthened in the future.

Maternal infection rates after cesarean delivery by Pfannenstiel or Joel-Cohen incision: a multicenter surveillance study.

PubMed

Dumas, Anne Marie; Girard, Raphaële; Ayzac, Louis; Caillat-Vallet, Emmanuelle; Tissot-Guerraz, Françoise; Vincent-Bouletreau, Agnès; Berland, Michel

2009-12-01

Our purpose was to evaluate maternal nosocomial infection rates according to the incision technique used for caesarean delivery, in a routine surveillance study. This was a prospective study of 5123 cesarean deliveries (43.2% Joel-Cohen, 56.8% Pfannenstiel incisions) in 35 maternity units (Mater Sud Est network). Data on routine surveillance variables, operative duration, and three additional variables (manual removal of the placenta, uterine exteriorization, and/or cleaning of the parieto-colic gutter) were collected. Multiple logistic regression analysis was used to identify independent risk factors for infection. The overall nosocomial infection and endometritis rates were higher for the Joel-Cohen than Pfannenstiel incision (4.5% vs. 3.3%, 0.8% vs. 0.3%, respectively). The higher rate of nosocomial infections with the Joel-Cohen incision was due to a greater proportion of patients presenting risk factors (i.e., emergency delivery, primary cesarean, blood loss > or =800 mL, no manual removal of the placenta and no uterine exteriorization). However, the Joel-Cohen technique was an independent risk factor for endometritis. The Joel-Cohen technique is faster than the Pfannenstiel technique but is associated with a higher incidence of endometritis.

Post-Caesarean Section Surgical Site Infection Surveillance Using an Online Database and Mobile Phone Technology.

PubMed

Castillo, Eliana; McIsaac, Corrine; MacDougall, Bhreagh; Wilson, Douglas; Kohr, Rosemary

2017-08-01

Obstetric surgical site infections (SSIs) are common and expensive to the health care system but remain under reported given shorter postoperative hospital stays and suboptimal post-discharge surveillance systems. SSIs, for the purpose of this paper, are defined according to the Center for Disease Control and Prevention (1999) as infection incurring within 30 days of the operative procedure (in this case, Caesarean section [CS]). Demonstrate the feasibility of real-life use of a patient driven SSIs post-discharge surveillance system consisting of an online database and mobile phone technology (surgical mobile app - how2trak) among women undergoing CS in a Canadian urban centre. Estimate the rate of SSIs and associated predisposing factors. Prospective cohort of consecutive women delivering by CS at one urban Canadian hospital. Using surgical mobile app-how2trak-predetermined demographics, comorbidities, procedure characteristics, and self-reported symptoms and signs of infection were collected and linked to patients' incision self-portraits (photos) on postpartum days 3, 7, 10, and 30. A total of 105 patients were enrolled over a 5-month period. Mean age was 31 years, 13% were diabetic, and most were at low risk of surgical complications. Forty-six percent of surgeries were emergency CSs, and 104/105 received antibiotic prophylaxis. Forty-five percent of patients (47/105) submitted at least one photo, and among those, one surgical site infection was detected by photo appearance and self-reported symptoms by postpartum day 10. The majority of patients whom uploaded photos did so multiple times and 43% of them submitted photos up to day 30. Patients with either a diagnosis of diabetes or self-reported Asian ethnicity were less likely to submit photos. Post-discharge surveillance for CS-related SSIs using surgical mobile app how2trak is feasible and deserves further study in the post-discharge setting. Copyright © 2017. Published by Elsevier Inc.

Diagnosed HIV Infection in Transgender Adults and Adolescents: Results from the National HIV Surveillance System, 2009–2014

PubMed Central

Clark, Hollie; Babu, Aruna Surendera; Wiewel, Ellen Weiss; Opoku, Jenevieve; Crepaz, Nicole

2017-01-01

Publications on diagnosed HIV infection among transgender people have been limited to state- or local-level data. We analyzed data from the National HIV Surveillance System and present results from the first national-level analysis of transgender people with diagnosed HIV infection. From 2009 to 2014, HIV surveillance jurisdictions from 45 states plus the District of Columbia identified and reported at least one case of newly diagnosed HIV infection for transgender people; jurisdictions from 5 states reported no cases for transgender people. Of 2351 transgender people with newly diagnosed HIV infection during 2009–2014, 84.0% were transgender women (male-to-female), 15.4% were transgender men (female-to-male), and 0.7% were additional gender identity (e.g., gender queer, bi-gender). Over half of both transgender women (50.8%; 1002/1974) and men (58.4%; 211/361) with newly diagnosed HIV infection were non-Hispanic black/African American. Improvements in data collection methods and quality are needed to gain a better understanding of HIV burden among transgender people. PMID:28035497

Prospective surveillance of device-associated health care-associated infection in an intensive care unit of a tertiary care hospital in New Delhi, India.

PubMed

Kumar, Shilpee; Sen, Poornima; Gaind, Rajni; Verma, Pardeep Kumar; Gupta, Poonam; Suri, Prem Rose; Nagpal, Sunita; Rai, Anil Kumar

2018-02-01

Surveillance of health care-associated infections (HAIs) plays a key role in the hospital infection control program and reduction of HAIs. In India, most of the surveillance of HAIs is reported from private sector hospitals that do not depict the situation of government sector hospitals. Other studies do not confirm with the Centers for Disease Control and Prevention's (CDC) National Healthcare Safety Network (NHSN) surveillance criterion, or deal with ventilator-associated pneumonia (VAP) instead of ventilator-associated event (VAE). The aim of this study was to identify the incidences of 3 device-associated HAIs (DA-HAIs) (VAE, central line-associated bloodstream infection [CLABSI], and catheter-associated urinary tract infection [CAUTI]) by active surveillance using CDC's NHSN surveillance criteria and to identify the pathogens associated with these DA-HAIs. This was a prospective surveillance study (January 2015-December 2016) conducted in an intensive care unit (ICU) of a large, tertiary care, government hospital situated in Delhi, India. Targeted surveillance was done as per the CDC's NHSN 2016 surveillance criteria. There were 343 patients admitted to the ICU that were included in the study. The surveillance data was reported over 3,755 patient days. A DA-HAIs attack rate of 20.1 per 100 admissions and incidence of 18.3 per 1,000 patient days was observed. The duration of use for each device for patients with DA-HAIs was significantly longer than for patients without DA-HAIs. The device utilization ratios of central line, ventilator, and urinary catheters were 0.57, 0.85, and 0.72, respectively. The crude excess length of stay for patients with DA-HAI was 13 days, and crude excess mortality rate was 11.8%. VAE, CLABSI, and CAUTI rates were 11.8, 7.4, and 9.7 per 1,000 device days, respectively. Among 69 DA-HAIs reported, pathogens could be identified for 49 DA-HAI cases. Klebsiella spp was the most common organism isolated, accounting 28.5% for all DA

Infection Surveillance Protocol for a Multicountry Population-based Study in South Asia to Determine the Incidence, Etiology and Risk Factors for Infections Among Young Infants of 0 to 59 Days Old.

PubMed

Islam, Mohammad Shahidul; Baqui, Abdullah H; Zaidi, Anita K; Bhutta, Zulfiqar A; Panigrahi, Pinaki; Bose, Anuradha; Soofi, Sajid B; Kazi, Abdul Momin; Mitra, Dipak K; Isaac, Rita; Nanda, Pritish; Connor, Nicholas E; Roth, Daniel E; Qazi, Shamim A; El Arifeen, Shams; Saha, Samir K

2016-05-01

Insufficient knowledge of the etiology and risk factors for community-acquired neonatal infection in low-income countries is a barrier to designing appropriate intervention strategies for these settings to reduce the burden and treatment of young infant infection. To address these gaps, we are conducting the Aetiology of Neonatal Infection in South Asia (ANISA) study among young infants in Bangladesh, India and Pakistan. The objectives of ANISA are to establish a comprehensive surveillance system for registering newborns in study catchment areas and collecting data on bacterial and viral etiology and associated risk factors for infections among young infants aged 0-59 days. We are conducting active surveillance in 1 peri-urban and 4 rural communities. During 2 years of surveillance, we expect to enroll an estimated 66,000 newborns within 7 days of their birth and to follow-up them until 59 days of age. Community health workers visit each young infant in the study area 3 times in the first week of life and once a week thereafter. During these visits, community health workers assess the newborns using a clinical algorithm and refer young infants with signs of suspected infection to health care facilities where study physicians reassess them and provide care if needed. On physician confirmation of suspected infection, blood and respiratory specimens are collected and tested to identify the etiologic agent. ANISA is one of the largest initiatives ever undertaken to understand the etiology of young infant infection in low-income countries. The data generated from this surveillance will help guide evidence-based decision making to improve health care in similar settings.

Potential Misclassification of Urinary Tract-Related Bacteremia Upon Applying the 2015 Catheter-Associated Urinary Tract Infection Surveillance Definition From the National Healthcare Safety Network.

PubMed

Greene, M Todd; Ratz, David; Meddings, Jennifer; Fakih, Mohamad G; Saint, Sanjay

2016-04-01

The Centers for Disease Control and Prevention recently updated the surveillance definition of catheter-associated urinary tract infection to include only urine culture bacteria of at least 1 × 10(5) colony-forming units/mL. Our findings suggest that the new surveillance definition may fail to capture clinically meaningful catheter-associated urinary tract infections.

Molecular identification of Aspergillus species collected for the Transplant-Associated Infection Surveillance Network.

PubMed

Balajee, S Arunmozhi; Kano, Rui; Baddley, John W; Moser, Stephen A; Marr, Kieren A; Alexander, Barbara D; Andes, David; Kontoyiannis, Dimitrios P; Perrone, Giancarlo; Peterson, Stephen; Brandt, Mary E; Pappas, Peter G; Chiller, Tom

2009-10-01

A large aggregate collection of clinical isolates of aspergilli (n = 218) from transplant patients with proven or probable invasive aspergillosis was available from the Transplant-Associated Infection Surveillance Network, a 6-year prospective surveillance study. To determine the Aspergillus species distribution in this collection, isolates were subjected to comparative sequence analyses by use of the internal transcribed spacer and beta-tubulin regions. Aspergillus fumigatus was the predominant species recovered, followed by A. flavus and A. niger. Several newly described species were identified, including A. lentulus and A. calidoustus; both species had high in vitro MICs to multiple antifungal drugs. Aspergillus tubingensis, a member of the A. niger species complex, is described from clinical specimens; all A. tubingensis isolates had low in vitro MICs to antifungal drugs.

Frontiers of parasitology research in the People's Republic of China: infection, diagnosis, protection and surveillance

PubMed Central

2012-01-01

Control and eventual elimination of human parasitic diseases in the People's Republic of China (P.R. China) requires novel approaches, particularly in the areas of diagnostics, mathematical modelling, monitoring, evaluation, surveillance and public health response. A comprehensive effort, involving the collaboration of 188 scientists (>85% from P.R. China) from 48 different institutions and universities (80% from P.R. China), covers this collection of 29 articles published in Parasites & Vectors. The research mainly stems from a research project entitled “Surveillance and diagnostic tools for major parasitic diseases in P.R. China” (grant no. 2008ZX10004-011) and highlights the frontiers of research in parasitology. The majority of articles in this thematic series deals with the most important parasitic diseases in P.R. China, emphasizing Schistosoma japonicum, Plasmodium vivax and Clonorchis sinensis plus some parasites of emerging importance such as Angiostrongylus cantonensis. Significant achievements have been made through the collaborative research programme in the following three fields: (i) development of strategies for the national control programme; (ii) updating the surveillance data of parasitic infections both in human and animals; and (iii) improvement of existing, and development of novel, diagnostic tools to detect parasitic infections. The progress is considerable and warrants broad validation efforts. Combined with the development of improved tools for diagnosis and surveillance, integrated and multi-pronged control strategies should now pave the way for elimination of parasitic diseases in P.R. China. Experiences and lessons learned can stimulate control and elimination efforts of parasitic diseases in other parts of the world. PMID:23036110

[Incidence of surgical site infection in ambulatory surgery: results of the INCISCO surveillance network in 1999-2000].

PubMed

Sewonou, A; Rioux, C; Golliot, F; Richard, L; Massault, P P; Johanet, H; Cherbonnel, G; Botherel, A H; Farret, D; Astagneau, P

2002-04-01

To estimate the incidence of surgical-site infections (SSI) in ambulatory surgery and to identify risk factors based on the surveillance network INCISO in 1999-2000. Annually, during a three-month period, each surgical ward had to include 200 consecutive operations. Patients were surveyed over the month following surgery. For each patient, data including peri-operative factors, type of procedure and SSI occurrence were collected on a standardized form by a surgical staff committed for the study. Of the 5,183 patients who underwent an ambulatory surgery, the SSI incidence ratio was 0.4% (95% CI [0.3-0.7]). Orthopedic, gynecologic/obstetrics, head and neck, skin and soft tissues surgery accounted for 83% of all ambulatory procedures. 93% of patients belonged to the 0 risk category of the National Nosocomial Infections Surveillance system (NNIS) index. Emergency, age, american anesthesia risk score (ASA), Altemeier wound class, and procedure duration were not found to be risk factors for SSI in ambulatory surgery. Based on these surveillance data, infectious risk was low in ambulatory surgery and was not associated with known SSI risk factors.

Surveillance of Zika virus infection in the EU/EEA, June 2015 to January 2017.

PubMed

Spiteri, G; Sudre, B; Septfons, A; Beauté, J

2017-10-01

Surveillance of Zika virus (ZIKV) infection in the European Union/European Economic Area (EU/EEA) was implemented in 2016 in response to the large outbreak reported in the Americas in 2015 associated with an increased number of infants born with microcephaly. Between June 2015 and January 2017, 21 EU/EEA countries reported 2,133 confirmed cases of ZIKV infection, of whom 106 were pregnant women. Cases infected in the Caribbean constituted 71% of reported cases. Almost all cases (99%) were most probably infected by mosquito bite during travel outside continental Europe, while only 1% were transmitted sexually. Considering that 584 imported cases were reported between May and October 2016 among residents of areas with established presence of Aedes albopictus , the absence of autochthonous vector-borne cases suggests that Ae. albopictus is not an efficient vector for ZIKV infection.

Impacts of Climate Anomalies on the Vegetation Patterns in the Arid and Semi-Arid Zones of Uzbekistan

NASA Astrophysics Data System (ADS)

Dildora, Aralova; Toderich, Kristina; Dilshod, Gafurov

2016-08-01

Steadily rising temperature anomalies in last decades are causing changes in vegetation patterns for sensitive to climate change in arid and semi-arid dryland ecosystems. After desiccation of the Aral Sea, Uzbekistan has been left with the challenge to develop drought and heat stress monitoring system and tools (e.g., to monitor vegetation status and/crop pattern dynamics) with using remote sensing technologies in broad scale. This study examines several climate parameters, NDVI and drought indexes within geostatistical method to predict further vegetation status in arid and semi-arid zones of landscapes. This approaches aimed to extract and utilize certain variable environmental data (temperature and precipitation) for assessment and inter-linkages of vegetation cover dynamics, specifically related to predict degraded and recovered zones or desertification process in the drylands due to scarcity of water resources and high risks of climate anomalies in fragile ecosystem of Uzbekistan.

Integrated Human Surveillance Systems of West Nile Virus Infections in Italy: The 2012 Experience

PubMed Central

Napoli, Christian; Bella, Antonino; Declich, Silvia; Grazzini, Giuliano; Lombardini, Letizia; Nanni Costa, Alessandro; Nicoletti, Loredana; Pompa, Maria Grazia; Pupella, Simonetta; Russo, Francesca; Rizzo, Caterina

2013-01-01

In Italy, a West Nile virus (WNV) surveillance plan was firstly implemented in 2008 and 2009 in two affected regions and, since 2010, according to a national plan, a WNV neuroinvasive disease (WNND) surveillance has to be carried out each year during the period 15 June–30 November, in those regions where WNV circulation has been demonstrated among humans, animals or vectors. Moreover, since WNV can be transmitted to humans even by blood transfusions and organ transplants obtained from infected donors, the national surveillance integrates the blood transfusions and organs transplant surveillances too. The paper describes the results of this integrated human surveillance in Italy in 2012. Overall, in 2012, 28 autochthonous confirmed cases of WNND were reported, 14 blood donations were found WNV positive by Nucleic Acid Amplification Test and no solid organ donors tested positive for WNV. Moreover, 17 cases of WNV fever were confirmed in Veneto region. When comparing the number of WNND cases reported to the surveillance system in previous 4 years (43 cases during the period 2008–2011), with those reported in 2012 an important increase was observed in 2012. The geographic distribution of human cases was consistent with the WNV circulation among animals and vectors. Moreover, the implementation of preventive measures for WNV transmission through blood components allowed the detection of blood donors positive for WNV, avoiding the further spread of the disease. Since surveillance strategies and preventive measures are based on the integration among human, animal and vector control activities, the Italian experience could be considered a good example of collaboration among different sectors of public health in a “one health” perspective. PMID:24351740

75 FR 15484 - Waiver of Restriction on Assistance to the Central Government of Uzbekistan Related to Budget...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-03-29

... DEPARTMENT OF STATE [Public Notice 6934] Waiver of Restriction on Assistance to the Central Government of Uzbekistan Related to Budget Transparency Pursuant to section 7086(c)(2) of the Department of State, Foreign Operations, and Related Programs Appropriations Act, 2010 (Division F, Pub. L. 111-117...

[Analysis on bacillary dysentery surveillance data collected from the National Surveillance System in 2007.].

PubMed

Zhong, Hao-jie; Chang, Zhao-rui; Zhang, Jing

2010-03-01

To improve the national surveillance plan on bacillary dysentery and to increase the sensitivity of the surveillance system on the disease. Data was collected through China Disease Reporting Information System (CDRIS) and National Sentinel Surveillance Sites on bacillary dysentery. Data from the CDRIS was compared with the data from the National Sentinel Surveillance to identify the exiting problems. Data from the monitoring sites showed that the detection rate of infant cases of bacillary dysentery infection was 1%, less than that of other age groups. The highest rates were seen in children aged 3 through 9 years. Rate on misdiagnosis in all age group was 23.38%, when using the surveillance case definition of clinical cases and suspect case. The rate of misdiagnosis on infant cases of bacillary dysentery infection by clinical diagnosis was 50%. It showed that Shigella flexneri and Shigella sonnei were dominant with the positive rates as 57.21% and 42.41%, respectively. From the national sentinel surveillance sites, the confirmed cases taking up 43.39% which did not match the figure from the CDRIS. The diagnostic criterion for bacillary dysentery fit well on other age groups in surveillance system except on infants. Active surveillance on bacillary dysentery that combining both clinical and laboratory diagnosis seems quite necessary on CDRIS, especially for infants.

Improving health care workers' protection against infection of Ebola hemorrhagic fever through video surveillance.

PubMed

Xi, Huijun; Cao, Jie; Liu, Jingjing; Li, Zhaoshen; Kong, Xiangyu; Wang, Yonghua; Chen, Jing; Ma, Su; Zhang, Lingjuan

2016-08-01

The purpose of this study was to investigate the importance of supervision through video surveillance in improving the quality of personal protection in preparing health care workers working in Ebola treatment units. Wardens supervise, remind, and guide health care workers' behavior through onsite voice and video systems when they are in the suspected patient observation ward and in the patient diagnosed ward of the Ebola treatment center. The observation results were recorded, and timely feedback was given to the health care workers. After 2 months of supervision, 1,797 cases of incorrect personal protection behaviors were identified and corrected. The error rate continuously declined. The declined rate of the first 2 weeks was statistically different from other time periods. Through reminding and supervising, nonstandard personal protective behaviors can be discovered and corrected, which can help health care workers standardize personal protection. The timely feedback from video surveillance can also offer psychologic support and encouragement promptly to ease psychologic pressure. Finally, this can ensure health care workers stay at a zero infection rate during patient treatment. Personal protective equipment protocol supervised by wardens through a video monitoring process can be used as an effective complement to conventional mutual supervision methods and can help health care workers avoid Ebola infection during treatment. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Population-Based Surveillance of Birth Defects Potentially Related to Zika Virus Infection - 15 States and U.S. Territories, 2016.

PubMed

Delaney, Augustina; Mai, Cara; Smoots, Ashley; Cragan, Janet; Ellington, Sascha; Langlois, Peter; Breidenbach, Rebecca; Fornoff, Jane; Dunn, Julie; Yazdy, Mahsa; Scotto-Rosato, Nancy; Sweatlock, Joseph; Fox, Deborah; Palacios, Jessica; Forestieri, Nina; Leedom, Vinita; Smiley, Mary; Nance, Amy; Lake-Burger, Heather; Romitti, Paul; Fall, Carrie; Prado, Miguel Valencia; Barton, Jerusha; Bryan, J Michael; Arias, William; Brown, Samara Viner; Kimura, Jonathan; Mann, Sylvia; Martin, Brennan; Orantes, Lucia; Taylor, Amber; Nahabedian, John; Akosa, Amanda; Song, Ziwei; Martin, Stacey; Ramlal, Roshan; Shapiro-Mendoza, Carrie; Isenburg, Jennifer; Moore, Cynthia A; Gilboa, Suzanne; Honein, Margaret A

2018-01-26

Zika virus infection during pregnancy can cause serious birth defects, including microcephaly and brain abnormalities (1). Population-based birth defects surveillance systems are critical to monitor all infants and fetuses with birth defects potentially related to Zika virus infection, regardless of known exposure or laboratory evidence of Zika virus infection during pregnancy. CDC analyzed data from 15 U.S. jurisdictions conducting population-based surveillance for birth defects potentially related to Zika virus infection.* Jurisdictions were stratified into the following three groups: those with 1) documented local transmission of Zika virus during 2016; 2) one or more cases of confirmed, symptomatic, travel-associated Zika virus disease reported to CDC per 100,000 residents; and 3) less than one case of confirmed, symptomatic, travel-associated Zika virus disease reported to CDC per 100,000 residents. A total of 2,962 infants and fetuses (3.0 per 1,000 live births; 95% confidence interval [CI] = 2.9-3.2) (2) met the case definition. † In areas with local transmission there was a non-statistically significant increase in total birth defects potentially related to Zika virus infection from 2.8 cases per 1,000 live births in the first half of 2016 to 3.0 cases in the second half (p = 0.10). However, when neural tube defects and other early brain malformations (NTDs) § were excluded, the prevalence of birth defects strongly linked to congenital Zika virus infection increased significantly, from 2.0 cases per 1,000 live births in the first half of 2016 to 2.4 cases in the second half, an increase of 29 more cases than expected (p = 0.009). These findings underscore the importance of surveillance for birth defects potentially related to Zika virus infection and the need for continued monitoring in areas at risk for Zika.

Surveillance of risk profiles among new and repeat blood donors with transfusion-transmissible infections from 1995 through 2003 in the Netherlands.

PubMed

Van der Bij, Akke K; Coutinho, Roel A; Van der Poel, Cees L

2006-10-01

To evaluate the effectiveness of blood donor selection, this study reports risk profiles of donors with transfusion-transmissible infections as obtained by ongoing surveillance, 1995 through 2003, in the Netherlands. A surveillance program was installed to monitor risk profiles among new and repeat donors infected with human immunodeficiency virus (HIV), hepatitis C virus (HCV), hepatitis B virus (HBV), or human T-lymphotropic virus (HTLV), or positive for the presence of syphilis antibodies. At posttest counseling, a physician interviewed donors to clarify possible sources of infection. A total of 167 repeat donors and 404 new donors were interviewed: 33 with HIV, 123 with HCV, 279 with HBV, 21 with HTLV, and 112 with syphilis antibodies. Most HBV, HCV, and HTLV infections were among new donors (80, 85, and 67%), whereas most HIV infections were among repeat donors (79%). Nearly 25 percent of the donors did not report factors at screening that would have deferred them from donating blood. At posttest interviews, new donors with HCV often reported injecting drug use (19%). Repeat donors with HIV often reported male-to-male sex (8/26, 31%). A significant level of deferrable behavioral risks was found among donors with confirmed transfusion-transmissible infections that persist despite current donor selection. Reporting such behavior at initial donor selection would have eliminated a substantial part of the infections found. This study argues against relaxing the existing donor deferral of persons practicing male-to-male sex, given their significant proportion of HIV infections among repeat donors. Systematic surveillance of risk factors among infected blood donors provides ongoing information about the effectivity of donor selection and is recommended to evaluate and optimize blood policies.

Population-based laboratory surveillance for Giardia sp. and Cryptosporidium sp. infections in a large Canadian health region

PubMed Central

Laupland, Kevin B; Church, Deirdre L

2005-01-01

Background Giardia lamblia (intestinalis) and Cryptosporidium parvum are the two most important intestinal parasites infecting North Americans but there is a paucity of active population-based surveillance data from Canada. This study determined the incidence of and demographic risk factors for developing Giardia sp. and Cryptosporidium sp. infections in a general Canadian population. Methods Population-based laboratory surveillance was conducted among all residents of the Calgary Health Region (CHR; population ≅ 1 million) during May 1, 1999 and April 30, 2002. Results Giardia sp. infection occurred at a rate of 19.6 per 100,000 populations per year. Although the yearly incidence was stable, a significant seasonal variation was observed with a peak in late summer to early fall. Males were at higher risk for development of this infection as compared to females (21.2 vs. 17.9 per 100,000/yr; relative risk (RR) 1.19; 95% confidence interval (CI), 1.00–1.40, p = 0.047), and there was a significant decrease in risk associated with an increasing age. Cryptosporidium sp. infection occurred at an overall rate of 6.0 per 100,000 populations per year although a large outbreak of Cryptosporidium sp. infections occurred in the second half of the summer of 2001. During August and September of 2001, the incidence of cryptosporidiosis was 55.1 per 100,000 per year as compared to 3.1 per 100,000 per year for the remainder of the surveillance period (p < 0.0001). Cryptosporidiosis was largely a disease of children with an incidence of 17.8 per 100,000 per year occurring among those aged < 20 years of age compared to 1.25 per 100,000 per year for adults ≥ 20 years of age (RR 14.19; 95% CI, 9.77–21.11; p < 0.0001). Conclusion This study provides important information on the occurrence and demographic risk groups for acquisition of giardiasis and cryptosporidiosis in a non-selected Canadian population. PMID:16168061

Identifying the Infection Control Areas Requiring Modifications in Thoracic Surgery Units: Results of a Two-Year Surveillance of Surgical Site Infections in Hospitals in Southern Poland.

PubMed

Dubiel, Grzegorz; Rogoziński, Paweł; Żaloudik, Elżbieta; Bruliński, Krzysztof; Różańska, Anna; Wójkowska-Mach, Jadwiga

2017-10-01

Surgical site infection (SSI) is considered to be a priority in infection control. The objective of this study is the analysis of results of active targeted surveillance conducted over a two-year period in the Department of Thoracic Surgery at the Pulmonology and Thoracic Surgery Center in Bystra, in southern Poland. The retrospective analysis was carried out on the basis of results of active monitoring of SSI in the 45-bed Department of Thoracic Surgery at the Pulmonology and Thoracic Surgery Center in Bystra between April 1, 2014 and April 30, 2016. Surgical site infections were identified based on the definitions of the European Centre for Disease Prevention and Control (ECDC) taking into account the time of symptom onset, specifically, whether the symptoms occurred within 30 d after the surgical procedure. Detection of SSI relied on daily inspection of incisions by a trained nurse, analysis of medical and nursing entries in the computer system, and analysis of all results of microbiologic tests taken in the unit and in the operating room. In the study period, data were collected regarding 1,387 treatment procedures meeting the registration criteria. Forty cases of SSI were detected yielding an incidence rate of 3%. Most cases (55%) were found in the course of hospitalization and 45% were detected after the patient's discharge. The SSIs were classified as follows: superficial, 37.5%; deep infections, 7.5%; and organ/space infection, 55%. Among patients who were diagnosed with SSI, most were male (77.5%). For patients with an American Society of Anesthesiologists (ASA) score I-II the incidence rate was 2%; ASA score III or more, 3.7%. The incidence rate varied from 0.3% in clean surgical site to 6.5% in clean-contaminated site. The study validated the usefulness of targeted surveillance in monitoring SSIs in patients hospitalized in thoracic surgery departments. Surgical site infection surveillance identified areas of care requiring modifications, namely

Standardised surveillance of Clostridium difficile infection in European acute care hospitals: a pilot study, 2013.

PubMed

van Dorp, Sofie M; Kinross, Pete; Gastmeier, Petra; Behnke, Michael; Kola, Axel; Delmée, Michel; Pavelkovich, Anastasia; Mentula, Silja; Barbut, Frédéric; Hajdu, Agnes; Ingebretsen, André; Pituch, Hanna; Macovei, Ioana S; Jovanović, Milica; Wiuff, Camilla; Schmid, Daniela; Olsen, Katharina Ep; Wilcox, Mark H; Suetens, Carl; Kuijper, Ed J

2016-07-21

Clostridium difficile infection (CDI) remains poorly controlled in many European countries, of which several have not yet implemented national CDI surveillance. In 2013, experts from the European CDI Surveillance Network project and from the European Centre for Disease Prevention and Control developed a protocol with three options of CDI surveillance for acute care hospitals: a 'minimal' option (aggregated hospital data), a 'light' option (including patient data for CDI cases) and an 'enhanced' option (including microbiological data on the first 10 CDI episodes per hospital). A total of 37 hospitals in 14 European countries tested these options for a three-month period (between 13 May and 1 November 2013). All 37 hospitals successfully completed the minimal surveillance option (for 1,152 patients). Clinical data were submitted for 94% (1,078/1,152) of the patients in the light option; information on CDI origin and outcome was complete for 94% (1,016/1,078) and 98% (294/300) of the patients in the light and enhanced options, respectively. The workload of the options was 1.1, 2.0 and 3.0 person-days per 10,000 hospital discharges, respectively. Enhanced surveillance was tested and was successful in 32 of the hospitals, showing that C. difficile PCR ribotype 027 was predominant (30% (79/267)). This study showed that standardised multicountry surveillance, with the option of integrating clinical and molecular data, is a feasible strategy for monitoring CDI in Europe. This article is copyright of The Authors, 2016.

Assessment of undiscovered continuous gas resources in the Amu Darya Basin Province of Turkmenistan, Uzbekistan, Iran, and Afghanistan, 2017

USGS Publications Warehouse

Schenk, Christopher J.; Tennyson, Marilyn E.; Mercier, Tracey J.; Hawkins, Sarah J.; Gaswirth, Stephanie B.; Marra, Kristen R.; Klett, Timothy R.; Le, Phuong A.; Brownfield, Michael E.; Woodall, Cheryl A.

2017-08-17

Using a geology-based assessment methodology, the U.S. Geological Survey estimated mean undiscovered, technically recoverable continuous resources of 35.1 trillion cubic feet of gas in the Amu Darya Basin Province of Turkmenistan, Uzbekistan, Iran, and Afghanistan.

Lessons learned from national food fortification projects: experiences from Morocco, Uzbekistan, and Vietnam.

PubMed

Wirth, James P; Laillou, Arnaud; Rohner, Fabian; Northrop-Clewes, Christine A; Macdonald, Barbara; Moench-Pfanner, Regina

2012-12-01

Fortification of staple foods has been repeatedly recommended as an effective approach to reduce micronutrient deficiencies. With the increased number of fortification projects globally, there is a need to share practical lessons learned relating to their implementation and responses to project-related and external challenges. To document the achievements, challenges, lessons learned, and management responses associated with national fortification projects in Morocco, Uzbekistan, and Vietnam. Independent end-of-project evaluations conducted for each project served as the primary data source and contain the history of and project activities undertaken for, each fortification project. Other sources, including national policy documents, project reports from the Global Alliance for Improved Nutrition (GAIN) and other stakeholders, industry assessments, and peer-reviewed articles, were used to document the current responses to challenges and future project plans. All projects had key achievements related to the development of fortification standards and the procurement of equipment for participating industry partners. Mandatory fortification of wheat flour was a key success in Morocco and Uzbekistan. Ensuring the quality of fortified foods was a common challenge experienced across the projects, as were shifts in consumption patterns and market structures. Adjustments were made to the projects' design to address the challenges faced. National fortification projects are dynamic and must be continually modified in response to specific performance issues and broader shifts in market structure and consumption patterns.

The Global Emerging Infection Surveillance and Response System (GEIS), a U.S. government tool for improved global biosurveillance: a review of 2009

PubMed Central

2011-01-01

The Armed Forces Health Surveillance Center, Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) has the mission of performing surveillance for emerging infectious diseases that could affect the United States (U.S.) military. This mission is accomplished by orchestrating a global portfolio of surveillance projects, capacity-building efforts, outbreak investigations and training exercises. In 2009, this portfolio involved 39 funded partners, impacting 92 countries. This article discusses the current biosurveillance landscape, programmatic details of organization and implementation, and key contributions to force health protection and global public health in 2009. PMID:21388562

Pelodera termitis sp. n. and two other rhabditid nematode species associated with the Turkestan termite Anacanthotermes turkestanicus from Uzbekistan

USDA-ARS?s Scientific Manuscript database

Biological, ecological and faunistic studies were made on two nematodes associated with mortality of the Turkestan termite, Anacanthotermes turkestanicus, in Uzbekistan. One of these is Caenorhabditis anacanthotermiae n. sp., morphologically similar in some regards to beetle-associated C. plicata an...

Luria in Uzbekistan: the vicissitudes of cross-cultural neuropsychology.

PubMed

Nell, V

1999-03-01

If the material conditions of culture shape cognitive structures, as Luria and Vygotsky argued, the "extraordinarily deep and rapid restructuring of historical forms" (Luria, 1971, 265) in the Soviet Republics that followed the Bolshevik revolution of 1917 provided a natural laboratory to determine whether processes of modernization changed traditional ways of thinking. This was the purpose of Luria's 1931 expedition to the Soviet Republic of Uzbekistan in central Asia. Luria's initial reports attracted vitriolic criticism because he had allegedly belittled "primitive" Uzbeki culture. The lasting importance of the Uzbek expedition is its emphasis on culture as a determinant of cognitive processes that remains valid to the present: in 1984, Gilbert replicated Luria's field studies in South Africa with near-identical results. Yet current neuropsychology has been slow to recognize the need for culturally sensitive assessment.

Imported infections: What information should be collected by surveillance systems to inform public health policy?

PubMed

Neave, Penny E; Heywood, Anita E; Gibney, Katherine B; Leder, Karin

2016-01-01

International travel carries the risk of imported diseases, which are an increasingly significant public health problem. There is little guidance about which variables should be collected by surveillance systems for strategy-based surveillance. Surveillance forms for dengue, malaria, hepatitis A, typhoid and measles were collected from Australia and New Zealand and information on these compared with national surveillance forms from the UK and Canada by travel health experts. Variables were categorised by information relating to recent travel, demographics and disease severity. Travel-related information most commonly requested included country of travel, vaccination status and travel dates. In Australia, ethnicity information requested related to indigenous status, whilst in New Zealand it could be linked to census categories. Severity of disease information most frequently collected were hospitalisation and death. Reviewing the usefulness of variables collected resulted in the recommendation that those included should be: overseas travel, reason for travel, entry and departure dates during the incubation period, vaccination details, traveller's and/or parents' country of birth, country of usual residence, time resident in current country, postcode, hospitalisation and death details. There was no agreement about whether ethnicity details should be collected. The inclusion of these variables on surveillance forms could enable imported infection-related policy to be formulated nationally and internationally. Copyright © 2016 Elsevier Ltd. All rights reserved.

Trends in Haemophilus influenzae type b infections in adults in England and Wales: surveillance study

PubMed Central

McVernon, Jodie; Trotter, Caroline L; Slack, Mary P E; Ramsay, Mary E

2004-01-01

Objective To describe invasive Haemophilus influenzae type b (Hib) infections in individuals aged 15 years or older in England and Wales between 1991 and 2003. Design Prospective, laboratory based surveillance of invasive Hib infections and cross sectional seroprevalence study. Setting England and Wales. Participants Cases were confirmed by isolation of H influenzae from a normally sterile site, or from a non-sterile site in cases with a diagnosis of epiglottitis. Excess serum samples collected from English 30-39 year olds as part of a national serosurvey were identified for the years 1990, 1994, 1997, 2000, and 2002. Main outcome measures The number of invasive Hib infections from 1991 to 2003. Population immunity to H influenzae type b in English adults was also measured. Results After routine infant immunisation was introduced in October 1992, adult Hib infections decreased initially but then rose from a low in 1998 to reach prevaccine levels in 2003. An associated fall in median Hib antibody concentrations occurred, from 1.29 μg/ml (95% confidence interval 0.90 to 1.64) in 1991 to 0.70 μg/ml (0.57 to 0.89) in 1994 (P = 0.006), with no significant change observed thereafter. Conclusions Although immunisation of infants resulted in an initial decline in Hib infections in adults, a resurgence in reported cases occurred in 2002-3. This rise was associated with an increase in cases in children and evidence of reduced immunity in older unimmunised cohorts. Childhood immunisation programmes may have unanticipated effects on the epidemiology of disease in older age groups, and surveillance strategies must be targeted at entire populations. PMID:15374916

Epidemiology of Clostridium difficile infections in Australia: enhanced surveillance to evaluate time trends and severity of illness in Victoria, 2010-2014.

PubMed

Worth, L J; Spelman, T; Bull, A L; Brett, J A; Richards, M J

2016-07-01

With epidemic strains of Clostridium difficile posing a substantial healthcare burden internationally, there is a need for longitudinal evaluation of Clostridium difficile infection (CDI) events in Australia. To evaluate time trends and severity of illness for CDI events in Australian healthcare facilities. All CDI events in patients admitted to Victorian public hospitals between 1(st) October 2010 and 31(st) December 2014 were reported to the Victorian Healthcare Associated Infection Surveillance System. CDI was defined as the isolation of a toxin-producing C. difficile organism in a diarrhoeal specimen, and classified as community-associated (CA-CDI) or healthcare-associated (HA-CDI). Severe disease was defined as admission to an intensive care unit, requirement for surgery and/or death due to infection. Time trends were examined using a mixed-effects Poisson regression model, and the Walter and Edward test of seasonality was applied to evaluate potential cyclical patterns. In total, 6736 CDI events were reported across 89 healthcare facilities. Of these, 4826 (71.6%) were HA-CDI, corresponding to a rate of 2.49/10,000 occupied bed days (OBDs). The incidence of HA-CDI was highest in the fifth quarter of surveillance (3.6/10,000 OBDs), followed by a reduction. Severe disease was reported in 1.66% of events, with the proportion being significantly higher for CA-CDI compared with HA-CDI (2.21 vs 1.45%, P = 0.03). The highest and lowest incidence of HA-CDI occurred in March and October, respectively. A low incidence of HA-CDI was reported in Victoria compared with US/European surveillance reports. Seasonality was evident, together with diminishing HA-CDI rates in 2012-2014. Severe infections were more common in CA-CDI, supporting future enhanced surveillance in community settings. Copyright © 2016 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

Surveillance of recent HIV infections among newly diagnosed HIV cases in Germany between 2008 and 2014.

PubMed

Hofmann, Alexandra; Hauser, Andrea; Zimmermann, Ruth; Santos-Hövener, Claudia; Bätzing-Feigenbaum, Jörg; Wildner, Stephan; Kücherer, Claudia; Bannert, Norbert; Hamouda, Osamah; Bremer, Viviane; Bartmeyer, Barbara

2017-07-11

The HIV surveillance system in Germany is based on mandatory, anonymous notification of newly diagnosed HIV cases by laboratories. Because the time between HIV infection and the diagnosis of HIV varies widely between persons, it is difficult to determine the number of cases of recent HIV infection among newly diagnosed cases of HIV. In Germany, the BED-capture-enzyme immunoassay (BED-CEIA) has been used to distinguish between recent and long-standing HIV infection. The aim of this analysis is to report the proportion of cases of recent HIV infection among newly diagnosed cases in Germany between 2008 and 2014 and to identify factors associated with recent infections. A sample of voluntary laboratories among all HIV diagnostic laboratories was recruited. Residual blood from HIV diagnostic tests was spotted on filter paper as dried serum or dried plasma spots and was sent along with the notification form of the HIV cases. The BED-CEIA test was performed. A case was defined as recent HIV infection with a BED-CEIA test result of less than 0.8 normalized optical density, with the exclusion of CDC stage C. The proportion of recent newly diagnosed HIV infections among different groups (such as transmission groups, gender or age groups) was calculated. We used logistic regression to identify factors associated with recent HIV infection and to identify subpopulations with high proportions of recent HIV infections. Approximately 10,257 newly diagnosed cases were tested for recency using the BED-CEIA. In total, 3084 (30.4%) of those were recently infected with HIV. The highest proportion of recent HIV infections was found among men who had sex with men (MSM) (35%) and persons between 18 and 25 years of age (43.0%). Logistic regression revealed that female German intravenous drug users with a recent HIV infection had a higher chance of being detected than German MSM (OR 2.27). Surveillance of recent HIV infection is a useful additional tool to monitor the HIV epidemic in

Transnational tobacco company influence on tax policy during privatization of a state monopoly: British American Tobacco and Uzbekistan.

PubMed

Gilmore, Anna; Collin, Jeff; Townsend, Joy

2007-11-01

The International Monetary Fund encourages privatization of state-owned tobacco industries. Privatization tends to lower cigarette prices, which encourages consumption. This could be countered with effective tax policies. We explored how investment by British American Tobacco (BAT) influenced tax policy in Uzbekistan during privatization there. We obtained internal documents from BAT and analyzed them using a hermeneutic process to create a chronology of events. BAT thoroughly redesigned the tobacco taxation system in Uzbekistan. It secured (1) a reduction of approximately 50% in the excise tax on cigarettes, (2) an excise system to benefit its brands and disadvantage those of its competitors (particularly Philip Morris), and (3) a tax stamp system from which it hoped to be exempted, because this would likely facilitate its established practice of cigarette smuggling and further its competitive advantage.. Privatization can endanger effective tobacco excise policies. The International Monetary Fund should review its approach to privatization and differentiate the privatization of an industry whose product kills from privatization of other industries.

Does surgical site infection after Caesarean section in Polish hospitals reflect high-quality patient care or poor postdischarge surveillance? Results from a 3-year multicenter study.

PubMed

Różańska, Anna; Jarynowski, Andrzej; Kopeć-Godlewska, Katarzyna; Wójkowska-Mach, Jadwiga; Misiewska-Kaczur, Agnieszka; Lech, Marzena; Rozwadowska, Małgorzata; Karwacka, Marlena; Liberda, Joanna; Domańska, Joanna

2018-01-01

Caesarean sections (CSs) are associated with a high infection risk. Surgical site infection (SSI) incidence is among the markers of effectiveness of infection prevention efforts. The aim of this study was to analyze risk factors for SSI, incidence, and microbiology in patients who underwent CS. The study was conducted during 2013-2015 using active infection surveillance in 5 Polish hospitals according to the European Centre for Disease Prevention and Control surveillance network known as HAI-Net. For each procedure, the following data were registered: age, American Society of Anesthesiologists score, procedure time, elective or emergency procedure, use of perioperative antibiotic prophylaxis, microbiology, the treatment used, and other information. SSI incidence was 0.5% and significant differences were noted among hospitals (between 0.1% and 1.8%), for different American Society of Anesthesiologists scales (between 0.2% and 4.8%) and different values of standardized SSI risk index (between 0.0% and 0.8%). In 3.1% of procedures, with no antibiotic prophylaxis, SSI risk was significantly higher. Deep infections dominated: 61.5% with superficial infections in only approximately 30% of cases and 2.6% of infections were detected postdischarge without readmissions. Results showed high incidence of SSI in Poland without perioperative antibiotic prophylaxis, and secondly, ineffective surveillance according to CS status, considering outpatient obstetric care. Without postdischarge surveillance, it is not possible to recognize the epidemiologic situation, and further, to set priorities and needs when it comes to infection prophylaxis, especially because such low incidence may indicate no need for improvement in infection control. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Land and water use practices intended to increase water productivity in arid and semi-arid zones. Application to Uzbekistan.

NASA Astrophysics Data System (ADS)

Mirshadiev, Mirzokhid; Fleskens, Luuk; van Dam, Jos; Pulatov, Alim

2017-04-01

Water demand increases as more food is required to meet population growth and higher living standards. In addition, climate change is expected to further exacerbate water scarcity in already dry areas where irrigation is most needed. In the water scarce areas, the key strategy to meet demand of growing food production and water use is increase of water productivity (WP) based on best land and water use practices. A literature review will be conducted to study promising land and water use practices that increase water productivity in arid and semi-arid zones, with a special focus on Uzbekistan. In addition to literature review we will conduct interviews with local farmers and land and water management experts. However, due to time constraints and difficult to access grey literature, the review paper cannot cover all promising land and water use practices that have been used in Uzbekistan. We selected the following promising practices: a) conventional furrow irrigation; b) deficit irrigation; c) drip/sprinkle irrigation, and d) rain-fed with supplemental irrigation. The preliminary findings of the literature review show that in Uzbekistan in case of conventional furrow irrigation the WP range of cotton was 0.32-0.89, and of wheat 0.44-1.77 (kg m3). By applying deficit irrigation practices, WP values of cotton can be 0-25% higher (0.32-1.11 kg m3), and of wheat 114-400% higher (2.20-3.78 kg m3). However, deficit irrigation practices for potato's need to be managed carefully to reach higher WP, and might even negatively effect WP, showing a range of 0.85-7.04 compared to conventional furrow irrigation 4.02-4.81 (kg m3). Important to mention that drip irrigation practice can highly contribute to increase WP of cotton by 156-91 % (0.82-1.70 kg m3) compared to furrow irrigation. Also, rain-fed cultivation with supplemental irrigation result is anticipated and will be included in the presentation and full version of paper. In summary, the review of current land and water

Use of surveillance data to identify target populations for Staphylococcus aureus vaccines and prevent surgical site infections: A pilot study

PubMed Central

Gustin, Marie-Paule; Giard, Marine; Bénet, Thomas; Vanhems, Philippe

2015-01-01

The development of anti-staphylococcal vaccines is nowadays a priority to prevent surgical site infections (SSI). The objective of the present study was to identify a potential target population by assessing surveillance data on surgery patients for possible anti-staphylococcal vaccine administration. Individuals at high risk of SSI by Staphylococcus aureus (SA) were targeted by the French SSI Surveillance Network in south-eastern France between 2008 and 2011. Among 238,470 patients, those undergoing primary total hip replacement appeared to be an interesting and healthy enough population for anti-staphylococcal vaccine testing. These male patients, subjected to multiple procedures and with American Society of Anesthesiologists score >2, had a probability of SA SSI about 21 times higher than females with no severe systemic disease and no multiple procedures. Our study indicates that surveillance data on SSI might be an interesting epidemiological source for planning vaccine trials to prevent nosocomial infections. PMID:25668663

Systematic review of electronic surveillance of infectious diseases with emphasis on antimicrobial resistance surveillance in resource-limited settings.

PubMed

Rattanaumpawan, Pinyo; Boonyasiri, Adhiratha; Vong, Sirenda; Thamlikitkul, Visanu

2018-02-01

Electronic surveillance of infectious diseases involves rapidly collecting, collating, and analyzing vast amounts of data from interrelated multiple databases. Although many developed countries have invested in electronic surveillance for infectious diseases, the system still presents a challenge for resource-limited health care settings. We conducted a systematic review by performing a comprehensive literature search on MEDLINE (January 2000-December 2015) to identify studies relevant to electronic surveillance of infectious diseases. Study characteristics and results were extracted and systematically reviewed by 3 infectious disease physicians. A total of 110 studies were included. Most surveillance systems were developed and implemented in high-income countries; less than one-quarter were conducted in low-or middle-income countries. Information technologies can be used to facilitate the process of obtaining laboratory, clinical, and pharmacologic data for the surveillance of infectious diseases, including antimicrobial resistance (AMR) infections. These novel systems require greater resources; however, we found that using electronic surveillance systems could result in shorter times to detect targeted infectious diseases and improvement of data collection. This study highlights a lack of resources in areas where an effective, rapid surveillance system is most needed. The availability of information technology for the electronic surveillance of infectious diseases, including AMR infections, will facilitate the prevention and containment of such emerging infectious diseases. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

The Results of Surgical Treatment of Cushing Tumors in the Republic of Uzbekistan: Establishing Transsphenoidal Surgery in A Developing Nation.

PubMed

Powell, Michael P; Narimova, Gulshekra J; Halimova, Zamira J

2017-01-01

Transsphenoidal surgery (TSS) was introduced into the Republic of Uzbekistan in 2005 and has been developing since then. The principal center for the management of all pituitary disease is a single site for a nation with a population of approximately 30 million. Results in surgery for Cushing disease are a marker of surgical technical skill in TSS. All previously published series come from the developed world, where sophisticated investigations and management are available. Many of these investigations are not available in Uzbekistan. This mixed series of 154 patients from 2000 to 2013 presents the data from Uzbekistan. The management of Cushing disease before the introduction of TSS was with unilateral adrenalectomy, a procedure virtually unknown in the West. It reduces cortisol burden but is, in the long-term, only a temporary measure because it allows the tumor to continue to grow. The results of this procedure are presented and show that in the short-term, surprisingly reasonable remission is obtained. These results are contrasted with the experience with TSS, for which the impact of the input from an experienced team including an endocrinologist and neurosurgeon from the United Kingdom allowed a transformation in management and enabled outcomes to match what can be expected in the West. TSS for Cushing's Disease achieved an early remission of 68.7% (early morning cortisol of <50 nmol/L), although 4 patients relapsed. Copyright © 2016 Elsevier Inc. All rights reserved.

Estimating Infection Attack Rates and Severity in Real Time during an Influenza Pandemic: Analysis of Serial Cross-Sectional Serologic Surveillance Data

PubMed Central

Wu, Joseph T.; Ho, Andrew; Ma, Edward S. K.; Lee, Cheuk Kwong; Chu, Daniel K. W.; Ho, Po-Lai; Hung, Ivan F. N.; Ho, Lai Ming; Lin, Che Kit; Tsang, Thomas; Lo, Su-Vui; Lau, Yu-Lung; Leung, Gabriel M.

2011-01-01

Background In an emerging influenza pandemic, estimating severity (the probability of a severe outcome, such as hospitalization, if infected) is a public health priority. As many influenza infections are subclinical, sero-surveillance is needed to allow reliable real-time estimates of infection attack rate (IAR) and severity. Methods and Findings We tested 14,766 sera collected during the first wave of the 2009 pandemic in Hong Kong using viral microneutralization. We estimated IAR and infection-hospitalization probability (IHP) from the serial cross-sectional serologic data and hospitalization data. Had our serologic data been available weekly in real time, we would have obtained reliable IHP estimates 1 wk after, 1–2 wk before, and 3 wk after epidemic peak for individuals aged 5–14 y, 15–29 y, and 30–59 y. The ratio of IAR to pre-existing seroprevalence, which decreased with age, was a major determinant for the timeliness of reliable estimates. If we began sero-surveillance 3 wk after community transmission was confirmed, with 150, 350, and 500 specimens per week for individuals aged 5–14 y, 15–19 y, and 20–29 y, respectively, we would have obtained reliable IHP estimates for these age groups 4 wk before the peak. For 30–59 y olds, even 800 specimens per week would not have generated reliable estimates until the peak because the ratio of IAR to pre-existing seroprevalence for this age group was low. The performance of serial cross-sectional sero-surveillance substantially deteriorates if test specificity is not near 100% or pre-existing seroprevalence is not near zero. These potential limitations could be mitigated by choosing a higher titer cutoff for seropositivity. If the epidemic doubling time is longer than 6 d, then serial cross-sectional sero-surveillance with 300 specimens per week would yield reliable estimates when IAR reaches around 6%–10%. Conclusions Serial cross-sectional serologic data together with clinical surveillance data can

Decreased rates of nosocomial endometritis and urinary tract infection after vaginal delivery in a French surveillance network, 1997-2003.

PubMed

Ayzac, Louis; Caillat-Vallet, Emmanuelle; Girard, Raphaële; Chapuis, Catherine; Depaix, Florence; Dumas, Anne-Marie; Gignoux, Chantal; Haond, Catherine; Lafarge-Leboucher, Joëlle; Launay, Carine; Tissot-Guerraz, Françoise; Vincent, Agnès; Fabry, Jacques

2008-06-01

To identify independent risk factors for endometritis and urinary tract infection (UTI) after vaginal delivery, and to monitor changes in nosocomial infection rates and derive benchmarks for prevention. Prospective study. We analyzed routine surveillance data for all vaginal deliveries between January 1997 and December 2003 at 66 maternity units participating in the Mater Sud-Est surveillance network. Adjusted odds ratios for risk of endometritis or UTI were obtained using a logistic regression model. The overall incidence rates were 0.5% for endometritis and 0.3% for UTI. There was a significant decrease in the incidence and risk of endometritis but not of UTI during the 7-year period. Significant risk factors for endometritis were fever during labor, parity of 1, and instrumental delivery and/or manual removal of the placenta. Significant risk factors for UTI were urinary infection on admission, premature rupture of membranes (more than 12 hours before admission), blood loss of more than 800 mL, parity of 1, instrumental delivery, and receipt of more than 5 vaginal digital examinations. Each maternity unit received a poster showing graphs of the number of expected and observed cases of UTI and endometritis associated with vaginal deliveries, which enabled each maternity unit to determine their rank within the network and to initiate prevention programs. Although routine surveillance means additional work for maternity units, our results demonstrate the usefulness of regular targeted monitoring of risk factors and of the most common nosocomial infections in obstetrics. Most of the information needed for monitoring is already present in the patients' records.

Passive surveillance of Leptospira infection in swine in Germany.

PubMed

Strutzberg-Minder, Katrin; Tschentscher, Astrid; Beyerbach, Martin; Homuth, Matthias; Kreienbrock, Lothar

2018-01-01

As no current data are available on the prevalence of leptospiral infection in swine in Germany, we analysed laboratory data from diagnostic examinations carried out on samples from swine all over Germany from January 2011 to September 2016. A total of 29,829 swine sera were tested by microscopic agglutination test (MAT) for antibodies against strains of eleven Leptospira serovars. Overall, 20.2% (6025) of the total sample collection tested positive for leptospiral infection. Seropositivity ranged between 16.3% (964) in 2011 and 30.9% (941) in 2016 (January to September only). Of all samples, 11.6% (57.3% of the positives) reacted with only one Leptospira serovar, and only 8.6% (42.7% of the positives) reacted simultaneously with two or more serovars. The most frequently detected serovar was Bratislava, which was found in 11.6% (3448) of all samples, followed by the serovars Australis in 7.3% (2185), Icterohaemorrhagiae in 4.0% (1191), Copenhageni in 4.0% (1182), Autumnalis in 3.7% (1054), Canicola in 2.0% (585), and Pomona in 1.2% (368). Modelling shows that both the year and the reason for testing at the laboratory had statistically strong effects on the test results; however, no interactions were determined between those factors. The results support the suggestion that the seropositivities found may be considered to indicate the state of leptospiral infections in the German swine population. Although data from passive surveillance are prone to selection bias, stratified analysis by initial reason for examination and analyses by model approaches may correct for biases. A prevalence of about 20% for a leptospiral infection is most probable for sows with reproductive problems in Germany, with an increasing trend. Swine in Germany are probably a reservoir host for serovar Bratislava, but in contrast to other studies not for Pomona and Tarassovi.

Low usage of government healthcare facilities for acute respiratory infections in guatemala: implications for influenza surveillance.

PubMed

Lindblade, Kim A; Johnson, April J; Arvelo, Wences; Zhang, Xingyou; Jordan, Hannah T; Reyes, Lissette; Fry, Alicia M; Padilla, Norma

2011-11-24

Sentinel surveillance for severe acute respiratory infections in hospitals and influenza-like illness in ambulatory clinics is recommended to assist in global pandemic influenza preparedness. Healthcare utilization patterns will affect the generalizability of data from sentinel sites and the potential to use them to estimate burden of disease. The objective of this study was to measure healthcare utilization patterns in Guatemala to inform the establishment of a sentinel surveillance system for influenza and other respiratory infections, and allow estimation of disease burden. We used a stratified, two-stage cluster survey sample to select 1200 households from the Department of Santa Rosa. Trained interviewers screened household residents for self-reported pneumonia in the last year and influenza-like illness (ILI) in the last month and asked about healthcare utilization for each illness episode. We surveyed 1131 (94%) households and 5449 residents between October and December 2006 and identified 323 (6%) cases of pneumonia and 628 (13%) cases of ILI. Treatment for pneumonia outside the home was sought by 92% of the children <5 years old and 73% of the persons aged five years and older. For both children <5 years old (53%) and persons aged five years and older (31%) who reported pneumonia, private clinics were the most frequently reported source of care. For ILI, treatment was sought outside the home by 81% of children <5 years old and 65% of persons aged five years and older. Government ambulatory clinics were the most frequently sought source of care for ILI both for children <5 years old (41%) and persons aged five years and older (36%). Sentinel surveillance for influenza and other respiratory infections based in government health facilities in Guatemala will significantly underestimate the burden of disease. Adjustment for healthcare utilization practices will permit more accurate estimation of the incidence of influenza and other respiratory pathogens in the

The invisible hand: how British American Tobacco precluded competition in Uzbekistan

PubMed Central

Gilmore, Anna B; McKee, Martin; Collin, Jeff

2007-01-01

Background Tobacco industry documents provide a unique opportunity to explore the role transnational corporations (TNCs) played in shaping the poor outcomes of privatisation in the former Soviet Union (FSU). This paper examines British American Tobacco's (BAT's) business conduct in Uzbekistan where large‐scale smuggling of BAT's cigarettes, BAT's reversal of tobacco control legislation and its human rights abuses of tobacco farmers have been documented previously. This paper focuses, instead, on BAT's attitude to competition, compares BAT's conduct with international standards and assesses its influence on the privatisation process. Methods Analysis of BAT documents released through litigation. Results BAT secured sole negotiator status precluding the Uzbekistan government from initiating discussions with other parties. Recognising that a competitive tender would greatly increase the cost of investment, BAT went to great lengths to avoid one, ultimately securing President Karimov's support and negotiating a monopoly position in a closed deal. It simultaneously secured exclusion from the monopolies committee, ensuring freedom to set prices, on the basis of a spurious argument that competition would exist from imports. Other anticompetitive moves comprised including all three plants in the deal despite intending to close down two, exclusive dealing and implementing measures designed to prevent market entry by competitors. BAT also secured a large number of exemptions and privileges that further reduced the government's revenue both on a one‐off and ongoing basis. Conclusions BAT's corporate misbehaviour included a wide number of anticompetitive practices, contravened Organisation of Economic Cooperation and Development's and BAT's own business standards on competition and restricted revenue arising from privatisation. This suggests that TNCs have contributed to the failure of privatisation in the FSU. Conducting open tenders and using enforceable codes to

Identifying newly acquired cases of hepatitis C using surveillance: a literature review.

PubMed

Sacks-Davis, R; VAN Gemert, C; Bergeri, I; Stoove, M; Hellard, M

2012-11-01

Surveillance of newly acquired hepatitis C virus (HCV) infection is crucial for understanding the epidemiology of HCV and informing public health practice. However, monitoring such infections via surveillance systems is challenging because they are commonly asymptomatic. A literature review was conducted to identify methodologies used by HCV surveillance systems to identify newly acquired infections; relevant surveillance systems in 15 countries were identified. Surveillance systems used three main strategies to identify newly acquired infections: (1) asking physicians to classify cases; (2) identifying symptomatic cases or cases with elevated alanine aminotransferases; and (3) identifying cases with documented evidence of anti-HCV antibody seroconversion within a specific time-frame. Case-ascertainment methods varied with greater completeness of data in enhanced compared to passive surveillance systems. Automated systems that extract and link testing data from multiple laboratory and clinic databases may provide an opportunity for collecting testing histories for individuals that is less resource intensive than enhanced surveillance.

Assessment of seismic risk in Tashkent, Uzbekistan and Bishkek, Kyrgyz Republic

USGS Publications Warehouse

Erdik, M.; Rashidov, T.; Safak, E.; Turdukulov, A.

2005-01-01

The impact of earthquakes in urban centers prone to disastrous earthquakes necessitates the analysis of associated risk for rational formulation of contingency plans and mitigation strategies. In urban centers the seismic risk is best quantified and portrayed through the preparation of 'Earthquake damage and Loss Scenarios'. The components of such scenarios are the assessment of the hazard, inventories and the vulnerabilities of elements at risk. For the development of earthquake risk scenario in Tashkent-Uzbekistan and Bishkek-Kyrgyzstan an approach based on spectral displacements is utilized. This paper will present the important features of a comprehensive study, highlight the methodology, discuss the results and provide insights to the future developments. ?? 2005 Elsevier Ltd. All rights reserved.

Implementing the ICPD Plan of Action in Central Asian Republics and Kazakhstan (CARAK). Uzbekistan. Squaring up to a demographic crisis.

PubMed

Karimov, S

1995-05-01

Uzbekistan's population of 20 million is growing at the annual rate of 2.5%. If this growth rate remains constant, the country's population will have grown to 35 million by the year 2015. The country is already showing signs of a demographic crisis, characterized by a rising level of infant and maternal mortality, a worsening of the general health status of the population, and a shorter life expectancy. There is no question, especially in the context of already difficult social and ecological circumstances, that Uzbekistan is in urgent need of a balanced, thoughtful population policy. The Health Minister, Dr. Shafkat Karimov, knows what is at stake and has a clear idea of how Uzbekistan's medical service will respond to the challenges ahead. Dr. Karimov points to the low health index of reproductive-age women and the spread of extragenital diseases as the main causes of the crisis. Frequent births by women suffering from extragenital diseases, short child spacing, and giving birth either too early or too late in life has led to high levels of infant morbidity and mortality. The minister plans to discourage early marriage, implement measures to bolster reproductive health, support maternal and child health care, provide contraception to meet unmet demand, and reduce levels of maternal undernutrition and mortality. Public centers have been established to deal with child and adolescent gynecology, as well as to prevent obstetric hemorrhage and extragenital diseases. Measures will also be taken with regard to the training of general practitioners and medical students.

Transnational Tobacco Company Influence on Tax Policy During Privatization of a State Monopoly: British American Tobacco and Uzbekistan

PubMed Central

Gilmore, Anna; Collin, Jeff; Townsend, Joy

2007-01-01

Objectives. The International Monetary Fund encourages privatization of state-owned tobacco industries. Privatization tends to lower cigarette prices, which encourages consumption. This could be countered with effective tax policies. We explored how investment by British American Tobacco (BAT) influenced tax policy in Uzbekistan during privatization there. Methods. We obtained internal documents from BAT and analyzed them using a hermeneutic process to create a chronology of events. Results. BAT thoroughly redesigned the tobacco taxation system in Uzbekistan. It secured (1) a reduction of approximately 50% in the excise tax on cigarettes, (2) an excise system to benefit its brands and disadvantage those of its competitors (particularly Philip Morris), and (3) a tax stamp system from which it hoped to be exempted, because this would likely facilitate its established practice of cigarette smuggling and further its competitive advantage.. Conclusions. Privatization can endanger effective tobacco excise policies. The International Monetary Fund should review its approach to privatization and differentiate the privatization of an industry whose product kills from privatization of other industries. PMID:17138915

Infection with Pathogens Transmitted Commonly Through Food and the Effect of Increasing Use of Culture-Independent Diagnostic Tests on Surveillance--Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2012-2015.

PubMed

Huang, Jennifer Y; Henao, Olga L; Griffin, Patricia M; Vugia, Duc J; Cronquist, Alicia B; Hurd, Sharon; Tobin-D'Angelo, Melissa; Ryan, Patricia; Smith, Kirk; Lathrop, Sarah; Zansky, Shelley; Cieslak, Paul R; Dunn, John; Holt, Kristin G; Wolpert, Beverly J; Patrick, Mary E

2016-04-15

To evaluate progress toward prevention of enteric and foodborne illnesses in the United States, the Foodborne Diseases Active Surveillance Network (FoodNet) monitors the incidence of laboratory-confirmed infections caused by nine pathogens transmitted commonly through food in 10 U.S. sites. This report summarizes preliminary 2015 data and describes trends since 2012. In 2015, FoodNet reported 20,107 confirmed cases (defined as culture-confirmed bacterial infections and laboratory-confirmed parasitic infections), 4,531 hospitalizations, and 77 deaths. FoodNet also received reports of 3,112 positive culture-independent diagnostic tests (CIDTs) without culture-confirmation, a number that has markedly increased since 2012. Diagnostic testing practices for enteric pathogens are rapidly moving away from culture-based methods. The continued shift from culture-based methods to CIDTs that do not produce the isolates needed to distinguish between strains and subtypes affects the interpretation of public health surveillance data and ability to monitor progress toward prevention efforts. Expanded case definitions and strategies for obtaining bacterial isolates are crucial during this transition period.

Social correlates of female infertility in Uzbekistan.

PubMed

Jumayev, Izatulla; Harun-Or-Rashid, Md; Rustamov, Oybek; Zakirova, Nodira; Kasuya, Hideki; Sakamoto, Junichi

2012-08-01

The purpose of this matched case-control study was to investigate the social correlates of primary infertility among females aged 35 years or less. The study was conducted in the Clinics of Samarkand Medical Institute, Uzbekistan, among 120 infertile and 120 healthy women matched by age, residential area, and occupation from January to June 2009. Data were collected by face-to-face interviews using a structured questionnaire. Median duration of infertility was 10.0 months (interquartile range = 6.0-13.0). The rate of remarriage was 3.5 times higher among infertile women compared with healthy subjects. Insufficient family income, poor quality of life, life stress, and discontentment with daily routines as well as 'bad' relationships with family members (husband, mother- and father-in-law) were significant correlates of female infertility. Infertile women were more likely to underestimate the importance of sexual intimacy, and a negative attitude to sex. Female infertility is associated with various social correlates leading to higher remarriage rates and to further complicating the problem of infertility. Thus, a correction of women's basic attitudes and their relationships to their surrounding social habitat should be an essential component of any program of infertility management.

Shifting the Paradigm: Using HIV Surveillance Data as a Foundation for Improving HIV Care and Preventing HIV Infection

PubMed Central

Sweeney, Patricia; Gardner, Lytt I; Buchacz, Kate; Garland, Pamela Morse; Mugavero, Michael J; Bosshart, Jeffrey T; Shouse, R Luke; Bertolli, Jeanne

2013-01-01

Context Reducing HIV incidence in the United States and improving health outcomes for people living with HIV hinge on improving access to highly effective treatment and overcoming barriers to continuous treatment. Using laboratory tests routinely reported for HIV surveillance to monitor individuals’ receipt of HIV care and contacting them to facilitate optimal care could help achieve these objectives. Historically, surveillance-based public health intervention with individuals for HIV control has been controversial because of concerns that risks to privacy and autonomy could outweigh benefits. But with the availability of lifesaving, transmission-interrupting treatment for HIV infection, some health departments have begun surveillance-based outreach to facilitate HIV medical care. Methods Guided by ethics frameworks, we explored the ethical arguments for changing the uses of HIV surveillance data. To identify ethical, procedural, and strategic considerations, we reviewed the activities of health departments that are using HIV surveillance data to contact persons identified as needing assistance with initiating or returning to care. Findings Although privacy concerns surrounding the uses of HIV surveillance data still exist, there are ethical concerns associated with not using HIV surveillance to maximize the benefits from HIV medical care and treatment. Early efforts to use surveillance data to facilitate optimal HIV medical care illustrate how the ethical burdens may vary depending on the local context and the specifics of implementation. Health departments laid the foundation for these activities by engaging stakeholders to gain their trust in sharing sensitive information; establishing or strengthening legal, policy and governance infrastructure; and developing communication and follow-up protocols that protect privacy. Conclusions We describe a shift toward using HIV surveillance to facilitate optimal HIV care. Health departments should review the

Methods for computational disease surveillance in infection prevention and control: Statistical process control versus Twitter's anomaly and breakout detection algorithms.

PubMed

Wiemken, Timothy L; Furmanek, Stephen P; Mattingly, William A; Wright, Marc-Oliver; Persaud, Annuradha K; Guinn, Brian E; Carrico, Ruth M; Arnold, Forest W; Ramirez, Julio A

2018-02-01

Although not all health care-associated infections (HAIs) are preventable, reducing HAIs through targeted intervention is key to a successful infection prevention program. To identify areas in need of targeted intervention, robust statistical methods must be used when analyzing surveillance data. The objective of this study was to compare and contrast statistical process control (SPC) charts with Twitter's anomaly and breakout detection algorithms. SPC and anomaly/breakout detection (ABD) charts were created for vancomycin-resistant Enterococcus, Acinetobacter baumannii, catheter-associated urinary tract infection, and central line-associated bloodstream infection data. Both SPC and ABD charts detected similar data points as anomalous/out of control on most charts. The vancomycin-resistant Enterococcus ABD chart detected an extra anomalous point that appeared to be higher than the same time period in prior years. Using a small subset of the central line-associated bloodstream infection data, the ABD chart was able to detect anomalies where the SPC chart was not. SPC charts and ABD charts both performed well, although ABD charts appeared to work better in the context of seasonal variation and autocorrelation. Because they account for common statistical issues in HAI data, ABD charts may be useful for practitioners for analysis of HAI surveillance data. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Forecasting ESKAPE infections through a time-varying auto-adaptive algorithm using laboratory-based surveillance data.

PubMed

Ballarin, Antonio; Posteraro, Brunella; Demartis, Giuseppe; Gervasi, Simona; Panzarella, Fabrizio; Torelli, Riccardo; Paroni Sterbini, Francesco; Morandotti, Grazia; Posteraro, Patrizia; Ricciardi, Walter; Gervasi Vidal, Kristian A; Sanguinetti, Maurizio

2014-12-06

Mathematical or statistical tools are capable to provide a valid help to improve surveillance systems for healthcare and non-healthcare-associated bacterial infections. The aim of this work is to evaluate the time-varying auto-adaptive (TVA) algorithm-based use of clinical microbiology laboratory database to forecast medically important drug-resistant bacterial infections. Using TVA algorithm, six distinct time series were modelled, each one representing the number of episodes per single 'ESKAPE' (E nterococcus faecium, S taphylococcus aureus, K lebsiella pneumoniae, A cinetobacter baumannii, P seudomonas aeruginosa and E nterobacter species) infecting pathogen, that had occurred monthly between 2002 and 2011 calendar years at the Università Cattolica del Sacro Cuore general hospital. Monthly moving averaged numbers of observed and forecasted ESKAPE infectious episodes were found to show a complete overlapping of their respective smoothed time series curves. Overall good forecast accuracy was observed, with percentages ranging from 82.14% for E. faecium infections to 90.36% for S. aureus infections. Our approach may regularly provide physicians with forecasted bacterial infection rates to alert them about the spread of antibiotic-resistant bacterial species, especially when clinical microbiological results of patients' specimens are delayed.

Evaluating the utility of syndromic surveillance algorithms for screening to detect potentially clonal hospital infection outbreaks

PubMed Central

Talbot, Thomas R; Schaffner, William; Bloch, Karen C; Daniels, Titus L; Miller, Randolph A

2011-01-01

Objective The authors evaluated algorithms commonly used in syndromic surveillance for use as screening tools to detect potentially clonal outbreaks for review by infection control practitioners. Design Study phase 1 applied four aberrancy detection algorithms (CUSUM, EWMA, space-time scan statistic, and WSARE) to retrospective microbiologic culture data, producing a list of past candidate outbreak clusters. In phase 2, four infectious disease physicians categorized the phase 1 algorithm-identified clusters to ascertain algorithm performance. In phase 3, project members combined the algorithms to create a unified screening system and conducted a retrospective pilot evaluation. Measurements The study calculated recall and precision for each algorithm, and created precision-recall curves for various methods of combining the algorithms into a unified screening tool. Results Individual algorithm recall and precision ranged from 0.21 to 0.31 and from 0.053 to 0.29, respectively. Few candidate outbreak clusters were identified by more than one algorithm. The best method of combining the algorithms yielded an area under the precision-recall curve of 0.553. The phase 3 combined system detected all infection control-confirmed outbreaks during the retrospective evaluation period. Limitations Lack of phase 2 reviewers' agreement indicates that subjective expert review was an imperfect gold standard. Less conservative filtering of culture results and alternate parameter selection for each algorithm might have improved algorithm performance. Conclusion Hospital outbreak detection presents different challenges than traditional syndromic surveillance. Nevertheless, algorithms developed for syndromic surveillance have potential to form the basis of a combined system that might perform clinically useful hospital outbreak screening. PMID:21606134

75 FR 74127 - In the Matter of the Review of the Designation of Islamic Movement of Uzbekistan (IMU and Other...

Federal Register 2010, 2011, 2012, 2013, 2014

2010-11-30

... DEPARTMENT OF STATE [Public Notice: 7250] In the Matter of the Review of the Designation of Islamic Movement of Uzbekistan (IMU and Other Aliases) as a Foreign Terrorist Organization Pursuant to Section 219 of the Immigration and Nationality Act, as Amended Based upon a review of the Administrative...

Antimicrobial resistance surveillance in the AFHSC-GEIS network

PubMed Central

2011-01-01

International infectious disease surveillance has been conducted by the United States (U.S.) Department of Defense (DoD) for many years and has been consolidated within the Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) since 1998. This includes activities that monitor the presence of antimicrobial resistance among pathogens. AFHSC-GEIS partners work within DoD military treatment facilities and collaborate with host-nation civilian and military clinics, hospitals and university systems. The goals of these activities are to foster military force health protection and medical diplomacy. Surveillance activities include both community-acquired and health care-associated infections and have promoted the development of surveillance networks, centers of excellence and referral laboratories. Information technology applications have been utilized increasingly to aid in DoD-wide global surveillance for diseases significant to force health protection and global public health. This section documents the accomplishments and activities of the network through AFHSC-GEIS partners in 2009. PMID:21388568

Antimicrobial resistance surveillance in the AFHSC-GEIS network.

PubMed

Meyer, William G; Pavlin, Julie A; Hospenthal, Duane; Murray, Clinton K; Jerke, Kurt; Hawksworth, Anthony; Metzgar, David; Myers, Todd; Walsh, Douglas; Wu, Max; Ergas, Rosa; Chukwuma, Uzo; Tobias, Steven; Klena, John; Nakhla, Isabelle; Talaat, Maha; Maves, Ryan; Ellis, Michael; Wortmann, Glenn; Blazes, David L; Lindler, Luther

2011-03-04

International infectious disease surveillance has been conducted by the United States (U.S.) Department of Defense (DoD) for many years and has been consolidated within the Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) since 1998. This includes activities that monitor the presence of antimicrobial resistance among pathogens. AFHSC-GEIS partners work within DoD military treatment facilities and collaborate with host-nation civilian and military clinics, hospitals and university systems. The goals of these activities are to foster military force health protection and medical diplomacy. Surveillance activities include both community-acquired and health care-associated infections and have promoted the development of surveillance networks, centers of excellence and referral laboratories. Information technology applications have been utilized increasingly to aid in DoD-wide global surveillance for diseases significant to force health protection and global public health. This section documents the accomplishments and activities of the network through AFHSC-GEIS partners in 2009.

Integrated analysis of human-animal-vector surveillance: West Nile virus infections in Austria, 2015-2016.

PubMed

Kolodziejek, Jolanta; Jungbauer, Christof; Aberle, Stephan W; Allerberger, Franz; Bagó, Zoltán; Camp, Jeremy V; Dimmel, Katharina; de Heus, Phebe; Kolodziejek, Michael; Schiefer, Peter; Seidel, Bernhard; Stiasny, Karin; Nowotny, Norbert

2018-03-14

The results of integrated human and veterinary surveillance for West Nile virus (WNV) infections in Austria during the transmission seasons 2015 and 2016 are shown. Altogether WNV nucleic acid was detected in 21 humans, horses, wild birds and mosquito pools. In detail: in four human clinical cases [two cases of West Nile fever (WNF) and two cases of West Nile neuroinvasive disease (WNND)]; eight blood donors [among 145,541 tested donations], of which three remained asymptomatic and five subsequently developed mild WNF; two horses with WNND, of which one recovered and one had to be euthanized; two wild birds [one goshawk and one falcon, both succumbed to WNND]; and five Culex pipiens mosquito pools. Compared to previous years the number of infections increased remarkably. All infections were recorded in the city of Vienna and neighboring regions of Lower Austria. Sixteen coding-complete WNV sequences were established which were closely related to each other and to other Austrian, Czech and Italian viruses, all belonging to the Central/Southern European cluster of WNV sublineage 2d. However, several genetically slightly different WNV strains seem to co-circulate in the same area, as demonstrated by phylogenetic analysis. Based on detailed sequence analysis, all newly discovered Austrian WNV strains had the potential to cause neurological disease, but no correlation was found between severity of disease and the analyzed genetic virulence/neuroinvasiveness markers. Results of integrated human-animal-vector surveillance presented in this paper provide a comprehensive description of WNV activity in the region and will facilitate proactive public health measures to prevent or mitigate potential outbreaks.

Implementation of a sentinel surveillance system for influenza-like illness (ILI) and severe acute respiratory infection (SARI) in the country of Georgia, 2015-2016.

PubMed

Chakhunashvili, Giorgi; Wagner, Abram L; Machablishvili, Ann; Karseladze, Irakli; Tarkhan-Mouravi, Olgha; Zakhashvili, Khatuna; Imnadze, Paata; Boulton, Matthew L

2017-12-01

Due to reports of substandard influenza preparedness, the country of Georgia developed two influenza surveillance systems. This paper describes these surveillance systems in their capacity to detect influenza. Two surveillance systems for influenza operate in Georgia: an influenza-like illness (ILI) sentinel surveillance system for out-patient cases, based in the capital, Tbilisi, and a severe acute respiratory infection (SARI) sentinel surveillance system for in-patient cases with five sentinel sites - one in Tbilisi, and four in Kutaisi. Patients in these surveillance systems provide samples for laboratory testing, including influenza confirmation. From 2015-2016, 825 cases were surveilled in the ILI surveillance system and 1367 cases were surveilled in the SARI surveillance system, with 222 (26.9%) and 451 (33.0%) positive for influenza, respectively. Influenza positivity varied by age with adults 30-64 years having highest proportion of influenza-positive cases at 42.2%. The sensitivity of the surveillance systems to influenza was relatively high compared to neighboring countries. These findings show the importance of influenza surveillance in the country of Georgia. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Electronic surveillance systems in infection prevention: Organizational support, program characteristics, and user satisfaction

PubMed Central

Grota, Patti G.; Stone, Patricia W.; Jordan, Sarah; Pogorzelska, Monika; Larson, Elaine

2012-01-01

Background The use of electronic surveillance systems (ESSs) is gradually increasing in infection prevention and control programs. Little is known about the characteristics of hospitals that have a ESS, user satisfaction with ESSs, and organizational support for implementation of ESSs. Methods A total of 350 acute care hospitals in California were invited to participate in a Web-based survey; 207 hospitals (59%) agreed to participate. The survey included a description of infection prevention and control department staff, where and how they spent their time, a measure of organizational support for infection prevention and control, and reported experience with ESSs. Results Only 23% (44/192) of responding infection prevention and control departments had an ESS. No statistically significant difference was seen in how and where infection preventionists (IPs) who used an ESS and those who did not spend their time. The 2 significant predictors of whether an ESS was present were score on the Organizational Support Scale (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.18) and hospital bed size (OR, 1.004; 95% CI, 1.00-1.007). Organizational support also was positively correlated with IP satisfaction with the ESS, as measured on the Computer Usability Scale (P = .02). Conclusion Despite evidence that such systems may improve efficiency of data collection and potentially improve patient outcomes, ESSs remain relatively uncommon in infection prevention and control programs. Based on our findings, organizational support appears to be a major predictor of the presence, use, and satisfaction with ESSs in infection prevention and control programs. PMID:20176411

Electronic surveillance systems in infection prevention: organizational support, program characteristics, and user satisfaction.

PubMed

Grota, Patti G; Stone, Patricia W; Jordan, Sarah; Pogorzelska, Monika; Larson, Elaine

2010-09-01

The use of electronic surveillance systems (ESSs) is gradually increasing in infection prevention and control programs. Little is known about the characteristics of hospitals that have a ESS, user satisfaction with ESSs, and organizational support for implementation of ESSs. A total of 350 acute care hospitals in California were invited to participate in a Web-based survey; 207 hospitals (59%) agreed to participate. The survey included a description of infection prevention and control department staff, where and how they spent their time, a measure of organizational support for infection prevention and control, and reported experience with ESSs. Only 23% (44/192) of responding infection prevention and control departments had an ESS. No statistically significant difference was seen in how and where infection preventionists (IPs) who used an ESS and those who did not spend their time. The 2 significant predictors of whether an ESS was present were score on the Organizational Support Scale (odds ratio [OR], 1.10; 95% confidence interval [CI], 1.02-1.18) and hospital bed size (OR, 1.004; 95% CI, 1.00-1.007). Organizational support also was positively correlated with IP satisfaction with the ESS, as measured on the Computer Usability Scale (P = .02). Despite evidence that such systems may improve efficiency of data collection and potentially improve patient outcomes, ESSs remain relatively uncommon in infection prevention and control programs. Based on our findings, organizational support appears to be a major predictor of the presence, use, and satisfaction with ESSs in infection prevention and control programs.

Low usage of government healthcare facilities for acute respiratory infections in guatemala: implications for influenza surveillance

PubMed Central

2011-01-01

Background Sentinel surveillance for severe acute respiratory infections in hospitals and influenza-like illness in ambulatory clinics is recommended to assist in global pandemic influenza preparedness. Healthcare utilization patterns will affect the generalizability of data from sentinel sites and the potential to use them to estimate burden of disease. The objective of this study was to measure healthcare utilization patterns in Guatemala to inform the establishment of a sentinel surveillance system for influenza and other respiratory infections, and allow estimation of disease burden. Methods We used a stratified, two-stage cluster survey sample to select 1200 households from the Department of Santa Rosa. Trained interviewers screened household residents for self-reported pneumonia in the last year and influenza-like illness (ILI) in the last month and asked about healthcare utilization for each illness episode. Results We surveyed 1131 (94%) households and 5449 residents between October and December 2006 and identified 323 (6%) cases of pneumonia and 628 (13%) cases of ILI. Treatment for pneumonia outside the home was sought by 92% of the children <5 years old and 73% of the persons aged five years and older. For both children <5 years old (53%) and persons aged five years and older (31%) who reported pneumonia, private clinics were the most frequently reported source of care. For ILI, treatment was sought outside the home by 81% of children <5 years old and 65% of persons aged five years and older. Government ambulatory clinics were the most frequently sought source of care for ILI both for children <5 years old (41%) and persons aged five years and older (36%). Conclusions Sentinel surveillance for influenza and other respiratory infections based in government health facilities in Guatemala will significantly underestimate the burden of disease. Adjustment for healthcare utilization practices will permit more accurate estimation of the incidence of influenza

Proposal for a sub-classification of hepato-biliary-pancreatic operations for surgical site infection surveillance following assessment of results of prospective multicenter data.

PubMed

Nakahira, Shin; Shimizu, Junzo; Miyamoto, Atsushi; Kobayashi, Shogo; Umeshita, Koji; Ito, Toshinori; Monden, Morito; Doki, Yuichiro; Mori, Masaki

2013-06-01

Surgical site infection (SSI) surveillance in Japan is based on the National Nosocomial Infection Surveillance system, which categorizes all hepato-biliary-pancreatic surgeries, except for cholecystectomy, into "BILI." We evaluated differences among BILI procedures to determine the optimal subdivision for SSI surveillance. We conducted multicenter SSI surveillance at 20 hospitals. BILI was subdivided into choledochectomy, pancreatoduodenectomy, hepatectomy, hepatectomy with biliary reconstruction, pancreatoduodenectomy with hepatectomy, distal pancreatectomy and total pancreatectomy to determine the optimal subdivision. The outcome of interest was SSI. Univariate and multivariate analyses were performed to determine the predictive significance of variables in each type of surgery. 1,926 BILI cases were included in this study. SSI rates were 23.2 % for all BILI; for choledochectomy 23.6 %, pancreatoduodenectomy 39.3 %, hepatectomy 12.8 %, hepatectomy with biliary reconstruction 41.9 %, pancreatoduodenectomy with hepatectomy 27.3 %, distal pancreatectomy 31.8 %, and total pancreatectomy 20.0 %. SSI rates for hepatectomy were significantly lower than those for non-hepatectomy BILI. Risk factors for developing SSI with hepatectomy were drain placement and long operative duration, while for non-hepatectomy BILI, risk factors were use of intra-abdominal silk sutures, SSI risk index and long operative duration. Hepatectomy and non-hepatectomy BILI differ with regard to the incidence of and risk factors for developing SSI. These surgeries should be assessed separately when conducting SSI surveillance.

SOCIAL CORRELATES OF FEMALE INFERTILITY IN UZBEKISTAN

PubMed Central

JUMAYEV, IZATULLA; HARUN-OR-RASHID, MD.; RUSTAMOV, OYBEK; ZAKIROVA, NODIRA; KASUYA, HIDEKI; SAKAMOTO, JUNICHI

2012-01-01

ABSTRACT The purpose of this matched case-control study was to investigate the social correlates of primary infertility among females aged 35 years or less. The study was conducted in the Clinics of Samarkand Medical Institute, Uzbekistan, among 120 infertile and 120 healthy women matched by age, residential area, and occupation from January to June 2009. Data were collected by face-to-face interviews using a structured questionnaire. Median duration of infertility was 10.0 months (interquartile range = 6.0–13.0). The rate of remarriage was 3.5 times higher among infertile women compared with healthy subjects. Insufficient family income, poor quality of life, life stress, and discontentment with daily routines as well as ‘bad’ relationships with family members (husband, mother- and father-in-law) were significant correlates of female infertility. Infertile women were more likely to underestimate the importance of sexual intimacy, and a negative attitude to sex. Female infertility is associated with various social correlates leading to higher remarriage rates and to further complicating the problem of infertility. Thus, a correction of women’s basic attitudes and their relationships to their surrounding social habitat should be an essential component of any program of infertility management. PMID:23092100

Leprosy exposure, infection and disease: a 25-year surveillance study of leprosy patient contacts.

PubMed

Sarno, Euzenir Nunes; Duppre, Nadia Cristina; Sales, Anna Maria; Hacker, Mariana Andréa; Nery, José Augusto; de Matos, Haroldo José

2012-12-01

Contact surveillance is a valuable strategy for controlling leprosy. A dynamic cohort study of leprosy contacts was initiated in 1987 at Oswaldo Cruz Foundation. The objective of this work was to review the data on the major risk factors leading up to the infectious stage of the disease, estimate incidence rates of leprosy in the cohort and characterise the risk factors for the disease among the contacts under surveillance. The incidence rate of leprosy among contacts of leprosy patients was estimated at 0.01694 cases per person-year in the first five years of follow-up. The following factors were associated with acquiring the disease: (i) not receiving the BCG vaccine, (ii) a negative Mitsuda reaction and (iii) contact with a patient with a multibacillary clinical form of leprosy. The contacts of index patients who had high bacilloscopic index scores > 1 were at especially high risk of infection. The following factors were associated with infection, which was defined as a seropositive reaction for anti-phenolic glicolipid-1 IgM: (i) young age (< 20 years), (ii) a low measured Mitsuda reaction (< 5 mm) and (iii) contact with an index patient who had a high bacilloscopic index. BCG vaccination and re-vaccination were shown to be protective among household contacts. The main conclusions of this study indicate an urgent need for additional leprosy control strategies in areas with a high incidence of the disease.

Development of a surgical site infection (SSI) surveillance system, calculation of SSI rates and specification of important factors affecting SSI in a digestive organ surgical department.

PubMed

Kimura, Koji; Sawa, Akihiro; Akagi, Shinji; Kihira, Kenji

2007-06-01

We have developed an original system to conduct surgical site infection (SSI) surveillance. This system accumulates SSI surveillance information based on the National Nosocomial Infections Surveillance (NNIS) System and the Japanese Nosocomial Infections Surveillance (JNIS) System. The features of this system are as follows: easy input of data, high generality, data accuracy, SSI rate by operative procedure and risk index category (RIC) can be promptly calculated and compared with the current NNIS SSI rate, and the SSI rates and accumulated data can be exported electronically. Using this system, we monitored 798 patients in 24 operative procedure categories in the Digestive Organs Surgery Department of Mazda Hospital, Mazda Motor Corporation, from January 2004 through December 2005. The total number and rate of SSI were 47 and 5.89%, respectively. The SSI rates of 777 patients were calculated based on 15 operative procedure categories and Risk Index Categories (RIC). The highest SSI rate was observed in the rectum surgery of RIC 1 (30%), followed by the colon surgery of RIC3 (28.57%). About 30% of the isolated infecting bacteria were Enterococcus faecalis, Staphylococcus aureus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Escherichia coli. Using quantification theory type 2, the American Society of Anesthesiology score (4.531), volume of hemorrhage under operation (3.075), wound classification (1.76), operation time (1.352), and history of diabetes (0.989) increased to higher ranks as factors for SSI. Therefore, we evaluated this system as a useful tool in safety control for operative procedures.

The effects of synoptic weather on influenza infection incidences: a retrospective study utilizing digital disease surveillance

NASA Astrophysics Data System (ADS)

Zhao, Naizhuo; Cao, Guofeng; Vanos, Jennifer K.; Vecellio, Daniel J.

2018-01-01

The environmental drivers and mechanisms of influenza dynamics remain unclear. The recent development of influenza surveillance-particularly the emergence of digital epidemiology-provides an opportunity to further understand this puzzle as an area within applied human biometeorology. This paper investigates the short-term weather effects on human influenza activity at a synoptic scale during cold seasons. Using 10 years (2005-2014) of municipal level influenza surveillance data (an adjustment of the Google Flu Trends estimation from the Centers for Disease Control's virologic surveillance data) and daily spatial synoptic classification weather types, we explore and compare the effects of weather exposure on the influenza infection incidences in 79 cities across the USA. We find that during the cold seasons the presence of the polar [i.e., dry polar (DP) and moist polar (MP)] weather types is significantly associated with increasing influenza likelihood in 62 and 68% of the studied cities, respectively, while the presence of tropical [i.e., dry tropical (DT) and moist tropical (MT)] weather types is associated with a significantly decreasing occurrence of influenza in 56 and 43% of the cities, respectively. The MP and the DP weather types exhibit similar close positive correlations with influenza infection incidences, indicating that both cold-dry and cold-moist air provide favorable conditions for the occurrence of influenza in the cold seasons. Additionally, when tropical weather types are present, the humid (MT) and the dry (DT) weather types have similar strong impacts to inhibit the occurrence of influenza. These findings suggest that temperature is a more dominating atmospheric factor than moisture that impacts the occurrences of influenza in cold seasons.

TerraSAR-X/TanDEM-X data for natural hazards research in mountainous regions of Uzbekistan

NASA Astrophysics Data System (ADS)

Semakova, Eleonora; Bühler, Yves

2017-07-01

Accurate and up-to-date digital elevation models (DEMs) are important tools for studying mountain hazards. We considered natural hazards related to glacier retreat, debris flows, and snow avalanches in two study areas of the Western Tien-Shan mountains, Uzbekistan. High-resolution DEMs were generated using single TerraSAR-X/TanDEM-X datasets. The high quality and actuality of the DEMs were proved through a comparison with Shuttle Radar Topography Mission, Advanced Spaceborne Emission and Reflection Radiometer, and Topo DEMs, using Ice, Cloud, and Land Elevation Satellite data as the reference dataset. For the first study area, which had high levels of economic activity, we applied the generated TanDEM-X DEM to an avalanche dynamics simulation using RAMMS software. Verification of the output results showed good agreement with field observations. For the second study area, with a wide spatial distribution of glaciers, we applied the TanDEM-X DEM to an assessment of glacier surface elevation changes. The results can be used to calculate the local mass balance in glacier ablation zones in other areas. Models were applied to estimate the probability of moraine-dammed lake formation and the affected area of a possible debris flow resulting from glacial lake outburst. The natural hazard research methods considered here will minimize costly ground observations in poorly accessible mountains and mitigate the impacts of hazards on the environment of Uzbekistan.

Encephalitis Surveillance through the Emerging Infections Program, 1997–2010

PubMed Central

Glaser, Carol A.

2015-01-01

Encephalitis is a devastating illness that commonly causes neurologic disability and has a case fatality rate >5% in the United States. An etiologic agent is identified in <50% of cases, making diagnosis challenging. The Centers for Disease Control and Prevention Emerging Infections Program (EIP) Encephalitis Project established syndromic surveillance for encephalitis in New York, California, and Tennessee, with the primary goal of increased identification of causative agents and secondary goals of improvements in treatment and outcome. The project represents the largest cohort of patients with encephalitis studied to date and has influenced case definition and diagnostic evaluation of this condition. Results of this project have provided insight into well-established causal pathogens and identified newer causes of infectious and autoimmune encephalitis. The recognition of a possible relationship between enterovirus D68 and acute flaccid paralysis with myelitis underscores the need for ongoing vigilance for emerging causes of neurologic disease. PMID:26295485

Surveillance, Auditing, and Feedback Can Reduce Surgical Site Infection Dramatically: Toward Zero Surgical Site Infection.

PubMed

Manivannan, Bhavani; Gowda, Deepak; Bulagonda, Pradeep; Rao, Abhishek; Raman, Sai Suguna; Natarajan, Shanmuga Vadivoo

2018-04-01

We evaluated the Surveillance of Surgical Site Infection (SSI), Auditing, and Feedback (SAF) effect on the rate of compliance with an SSI care bundle and measured its effectiveness in reducing the SSI rate. A prospective cohort study from January 2014 to December 2016 was classified into three phases: pre-SAF, early-SAF, and late-SAF. Pre-operative baseline characteristics of 24,677 patients who underwent orthopedic, cardiovascular thoracic surgery (CTVS) or urologic operations were recorded. Univariable analyses of the SSI rates in the pre-SAF and post-SAF phases were performed. Percentage compliance and non-compliance with each care component were calculated. Correlation between reduction in the SSI rate and increase in compliance with the pre-operative, peri-operative, and post-operative care-bundle components was performed using the Spearman test. There was a significant decrease in the SSI rate in orthopedic procedures that involved surgical implantation and in mitral valve/aortic valve (MVR/AVR) cardiac operations, with a relative risk (RR) ratio of 0.19 (95% confidence interval [CI] 0.12-0.31) and 0.08 (95% CI 0.03-0.22), respectively. The SSI rate was inversely correlated with the rate of compliance with pre-operative (r = -0.738; p = 0.037), peri-operative (r = - 0.802; p = 0.017), and post-operative (r = -0.762; p = 0.028) care bundles. Implementation of the Surveillance of SSI, Auditing, and Feedback bundle had a profound beneficial effect on the SSI rate, thereby reducing healthcare costs and improving patient quality of life.

The rationale for integrated childhood meningoencephalitis surveillance: a case study from Cambodia

PubMed Central

Touch, Sok; Hills, Susan; Rani, Manju; Samnang, Chham; Khalakdina, Asheena; Jacobson, Julie

2009-01-01

Abstract Problem Recent progress in vaccine availability and affordability has raised prospects for reducing death and disability from neurological infections in children. In many Asian countries, however, the epidemiology and public health burden of neurological diseases such as Japanese encephalitis and bacterial meningitis are poorly understood. Approach A sentinel surveillance system for Japanese encephalitis was developed and embedded within the routine meningoencephalitis syndromic surveillance system in Cambodia in 2006. The sentinel surveillance system was designed so surveillance and laboratory testing for other etiologies of neurological infection could be incorporated. Local setting The Communicable Disease Control department of the Ministry of Health in Cambodia worked with partners to establish the sentinel surveillance system. Relevant changes The sentinel surveillance system has provided important information on the disease burden of Japanese encephalitis in Cambodia and is now providing a platform for expansion to incorporate laboratory testing for other vaccine-preventable neurological infections in children. Lessons learned Sentinel surveillance systems, when linked to syndromic reporting systems, can characterize the epidemiology of meningoencephalitis and identify the proportion of hospital-based neurological infection in children that is vaccine preventable. Integrated systems enable consistency in data collection, analysis and information dissemination, and they enhance the capacity of public health managers to provide more credible and integrated information to policy-makers. This will assist decision-making about the potential role of immunization in reducing the incidence of childhood neurological infections. PMID:19551241

Results of the national surveillance of antimicrobial resistance of Enterobacteriaceae and Gram negative bacilli in health care-associated infections in Colombia, 2012-2014.

PubMed

Ovalle, María Victoria; Saavedra, Sandra Yamile; González, María Nilse; Hidalgo, Andrea Melissa; Duarte, Carolina; Beltrán, Mauricio

2017-12-01

The Colombian National Antimicrobial Resistance Monitoring System for the surveillance of healthcare-associated infections was set up to meet this problem in the third quarter of 2012. To describe resistance profiles and laboratory-based surveillance based on the information collected by the System. We conducted a retrospective and descriptive study of the information notified to the Colombian Public Health Surveillance System (Sivigila), and in the Whonet databases covering the period from July 2012 to December 2014 provided by the primary data-generating units in the country, as well as laboratory surveillance results from 1,642 phenotypic and genotypic tests on carbapenemase isolates (927 from Enterobacteriaceae, 614 from Pseudomonas spp. and 101 from Acinetobacter spp.). There was a significant increase in Escherichia coli resistance to third-generation cephalosporins (reaching 26.3% in ICUs and 22.5% in other hospital wards), and Klebsiella pneumoniae resistance to ertapenem also increased (reaching 14.6% in ICUs). Acinetobacter baumannii carbapenem resistance exceeded 50% in ICUs whereas Pseudomonas aeruginosa had lower carbapenem resistance (38.8%). KPC (n = 574) and NDM (n=57) were the most frequently occurring carbapenemases in Enterobacteriaceae, VIM (n=229) and KPC (n=114) in P. aeruginosa, and OXA-23 in A. baumannii (n=87); several carbapenemase combinations were identified, KPC + VIM being the most common in Pseudomonas spp. and Enterobacteriaceae. The data from the surveillance of healthcare-associated infections revealed significant carbapenem resistance profiles and antimicrobial resistance mechanisms circulating in Colombian healthcare institutions.

A generic rabies risk assessment tool to support surveillance.

PubMed

Ward, Michael P; Hernández-Jover, Marta

2015-06-01

The continued spread of rabies in Indonesia poses a risk to human and animal populations in the remaining free islands, as well as the neighbouring rabies-free countries of Timor Leste, Papua New Guinea and Australia. Here we describe the development of a generic risk assessment tool which can be used to rapidly determine the vulnerability of rabies-free islands, so that scarce resources can be targeted to surveillance activities and the sensitivity of surveillance systems increased. The tool was developed by integrating information on the historical spread of rabies, anthropological studies, and the opinions of local animal health experts. The resulting tool is based on eight critical parameters that can be estimated from the literature, expert opinion, observational studies and information generated from routine surveillance. In the case study presented, results generated by this tool were most sensitive to the probability that dogs are present on private and fishing boats and it was predicted that rabies-infection (one infected case) might occur in a rabies-free island (upper 95% prediction interval) with a volume of 1000 boats movements. With 25,000 boat movements, the median of the probability distribution would be equal to one infected case, with an upper 95% prediction interval of six infected cases. This tool could also be used at the national-level to guide control and eradication plans. An initial recommendation from this study is to develop a surveillance programme to determine the likelihood that boats transport dogs, for example by port surveillance or regularly conducted surveys of fisherman and passenger ferries. However, the illegal nature of dog transportation from rabies-infected to rabies-free islands is a challenge for developing such surveillance. Copyright © 2014 Elsevier B.V. All rights reserved.

Tracking Pertussis and Evaluating Control Measures through Enhanced Pertussis Surveillance, Emerging Infections Program, United States

PubMed Central

Baumbach, Joan; Cieslak, Paul R.

2015-01-01

Despite high coverage with pertussis-containing vaccines, pertussis remains endemic to the United States. There have been increases in reported cases in recent years, punctuated by striking epidemics and shifting epidemiology, both of which raise questions about current policies regarding its prevention and control. Limited data on pertussis reported through the National Notifiable Disease Surveillance System have proved insufficient to answer these questions. To address shortcomings of national pertussis data, the Emerging Infections Program at the US Centers for Disease Control and Prevention launched Enhanced Pertussis Surveillance (EPS), which is characterized by systematic case ascertainment, augmented data collection, and collection of Bordetella pertussis isolates. Data collected through EPS have been instrumental in understanding the rapidly evolving epidemiology and molecular epidemiology of pertussis and have contributed essential information regarding pertussis vaccines. EPS also serves as a platform for conducting critical and timely evaluations of pertussis prevention and control strategies, including targeting of vaccinations and antimicrobial prophylaxis. PMID:26291475

Incidence and Trends of Infections with Pathogens Transmitted Commonly Through Food and the Effect of Increasing Use of Culture-Independent Diagnostic Tests on Surveillance - Foodborne Diseases Active Surveillance Network, 10 U.S. Sites, 2013-2016.

PubMed

Marder, Ellyn P; Cieslak, Paul R; Cronquist, Alicia B; Dunn, John; Lathrop, Sarah; Rabatsky-Ehr, Therese; Ryan, Patricia; Smith, Kirk; Tobin-D'Angelo, Melissa; Vugia, Duc J; Zansky, Shelley; Holt, Kristin G; Wolpert, Beverly J; Lynch, Michael; Tauxe, Robert; Geissler, Aimee L

2017-04-21

Foodborne diseases represent a substantial public health concern in the United States. CDC's Foodborne Diseases Active Surveillance Network (FoodNet) monitors cases reported from 10 U.S. sites* of laboratory-diagnosed infections caused by nine enteric pathogens commonly transmitted through food. This report describes preliminary surveillance data for 2016 on the nine pathogens and changes in incidences compared with 2013-2015. In 2016, FoodNet identified 24,029 infections, 5,512 hospitalizations, and 98 deaths caused by these pathogens. The use of culture-independent diagnostic tests (CIDTs) by clinical laboratories to detect enteric pathogens has been steadily increasing since FoodNet began surveying clinical laboratories in 2010 (1). CIDTs complicate the interpretation of FoodNet surveillance data because pathogen detection could be affected by changes in health care provider behaviors or laboratory testing practices (2). Health care providers might be more likely to order CIDTs because these tests are quicker and easier to use than traditional culture methods, a circumstance that could increase pathogen detection (3). Similarly, pathogen detection could also be increasing as clinical laboratories adopt DNA-based syndromic panels, which include pathogens not often included in routine stool culture (4,5). In addition, CIDTs do not yield isolates, which public health officials rely on to distinguish pathogen subtypes, determine antimicrobial resistance, monitor trends, and detect outbreaks. To obtain isolates for infections identified by CIDTs, laboratories must perform reflex culture † ; if clinical laboratories do not, the burden of culturing falls to state public health laboratories, which might not be able to absorb that burden as the adoption of these tests increases (2). Strategies are needed to preserve access to bacterial isolates for further characterization and to determine the effect of changing trends in testing practices on surveillance.

Assessment of the accuracy and consistency in the application of standardized surveillance definitions: A summary of the American Journal of Infection Control and National Healthcare Safety Network case studies, 2010-2016.

PubMed

Wright, Marc-Oliver; Allen-Bridson, Katherine; Hebden, Joan N

2017-06-01

The Centers for Disease Control and Prevention (CDC) National Healthcare Safety Network (NHSN) surveillance definitions are the most widely used criteria for health care-associated infection (HAI) surveillance. NHSN participants agree to conduct surveillance in accordance with the NHSN protocol and criteria. To assess the application of these standardized surveillance specifications and offer infection preventionists (IPs) opportunities for ongoing education, a series of case studies, with questions related to NHSN definitions and criteria were published. Beginning in 2010, case studies with multiple-choice questions based on standard surveillance criteria and protocols were written and published in the American Journal of Infection Control with a link to an online survey. Participants anonymously submitted their responses before receiving the correct answers. The 22 case studies had 7,950 respondents who provided 27,790 responses to 75 questions during the first 6 years. Correct responses were selected 62.5% of the time (17,376 out of 27,290), but ranged widely (16%-87%). In a subset analysis, 93% of participants self-identified as IPs (3,387 out of 3,640), 4.5% were public health professionals (163 out of 3,640), and 2.5% were physicians (90 out of 3,640). IPs responded correctly (62%) more often than physicians (55%) (P = .006). Among a cohort of voluntary participants, accurate application of surveillance criteria to case studies was suboptimal, highlighting the need for continuing education, competency development, and auditing. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. All rights reserved.

Investigating aquatic ecosystems of small lakes in Khorezm, Uzbekistan

USGS Publications Warehouse

Saito, L.; Scott, J.; Rosen, M.; Nishonov, Bakhriddin; Chandra, S.; Lamers, John P.A.; Fayzieva, Dilorom; Shanafield, M.

2009-01-01

The Khorezm province of Uzbekistan, located in the Aral Sea Basin, suffers from severe environmental and human health problems due to decades of unsustainable land and water management. Agriculture is the dominant land use in Khorezm, and agricultural runoff water has impacted many small lakes. In this water-scarce region, these lakes may provide a water source for irrigation or fish production. Samples have been collected from 13 of these lakes since 2006 to assess water quality, the aquatic food web, and possible limits to aquatic production. Lake salinity varied from 1 to >10 g/L both between and within lakes. Although hydrophobic contaminants concentrations were low (82-241 pg toxic equivalents/mL in June 2006, October 2006, and June 2007), aquatic species diversity and relative density were low in most lakes. Ongoing work is focused on 4 lakes with pelagic food webs to estimate fish production and assess anthropogenic impacts on the food web. Lake sediment cores are also being examined for organic contaminants, and hydrology is being assessed with stable isotopes. ?? 2009 ASCE.

The Spanish national health care-associated infection surveillance network (INCLIMECC): data summary January 1997 through December 2006 adapted to the new National Healthcare Safety Network Procedure-associated module codes.

PubMed

Pérez, Cristina Díaz-Agero; Rodela, Ana Robustillo; Monge Jodrá, Vincente

2009-12-01

In 1997, a national standardized surveillance system (designated INCLIMECC [Indicadores Clínicos de Mejora Continua de la Calidad]) was established in Spain for health care-associated infection (HAI) in surgery patients, based on the National Nosocomial Infection Surveillance (NNIS) system. In 2005, in its procedure-associated module, the National Healthcare Safety Network (NHSN) inherited the NNIS program for surveillance of HAI in surgery patients and reorganized all surgical procedures. INCLIMECC actively monitors all patients referred to the surgical ward of each participating hospital. We present a summary of the data collected from January 1997 to December 2006 adapted to the new NHSN procedures. Surgical site infection (SSI) rates are provided by operative procedure and NNIS risk index category. Further quality indicators reported are surgical complications, length of stay, antimicrobial prophylaxis, mortality, readmission because of infection or other complication, and revision surgery. Because the ICD-9-CM surgery procedure code is included in each patient's record, we were able to reorganize our database avoiding the loss of extensive information, as has occurred with other systems.

Case Finding Using Syndromic Surveillance Data During an Outbreak of Shiga Toxin-Producing Escherichia coli O26 Infections, Oregon, 2015.

PubMed

Hines, Jonas Z; Bancroft, June; Powell, Melissa; Hedberg, Katrina

Shiga toxin-producing Escherichia coli (STEC) causes an estimated 265 000 infections in the United States annually. Of emerging non-O157:H7 STEC serotypes, O26 is the most commonly recognized. During an outbreak of STEC O26 in Oregon in 2015, we used syndromic surveillance data to supplement case finding by laboratory reporting. From 157 records retrieved by querying syndromic surveillance data, we detected 4 confirmed and 5 suspected cases. However, none of the suspected cases were confirmed by stool culture, and by the time that the data were being analyzed, the confirmed cases were already known to investigators. Syndromic surveillance data can potentially supplement case finding during outbreaks of foodborne disease. To be an effective case-finding strategy, timely completion of all steps, including collecting specimens from suspected cases, should be performed in real time.

Airport sentinel surveillance and entry quarantine for dengue infections following a fever screening program in Taiwan.

PubMed

Kuan, Mei-Mei; Chang, Feng-Yee

2012-08-06

Dengue has not reached an endemic status in Taiwan; nevertheless, we have implemented a fever screening program at airports for the early detection of febrile passengers with a dengue infection. This study is intended to assess the performance of the airport screening procedures for dengue infection. We analyzed data from the national surveillance system of the Taiwan Centers for Disease Control. We included the imported dengue cases reported by sentinel airports and clinics as well as the domestic cases from 2007-2010. Approximately 44.9% (95%CI: 35.73-54.13%) of the confirmed imported dengue cases with an apparent symptom (febrile) in the viremic stage were detected via the airport fever screening program, with an estimated positive predictive value of 2.36% (95% CI: 0.96- 3.75%) and a negative predictive value > 99.99%. Fluctuations in the number of the symptomatic imported dengue cases identified in the airports (X) were associated with the total number of imported dengue cases (Y) based on a regression analysis of a biweekly surveillance (i.e., n = 104, R(2)(X:Y) = 0.61, P < 0.005). Additionally, the fluctuating patterns in the cumulative numbers of the imported dengue cases (X) with a 1-2 month lead time (t) was in parallel with that of the domestic dengue cases (Y) based on a consecutive 4-year surveillance (i.e., n = 48, R(2)(X(t-1):Y) = 0.22, R(2)(X(t-2):Y) = 0.31, P < 0.001) from 2007-2010. A moderate sensitivity of detecting dengue at the airports examined in this study indicated some limitations of the fever screening program for the prevention of importation. The screening program could assist in the rapid triage for self-quarantine of some symptomatic dengue cases that were in the viremic stage at the borders and contribute to active sentinel surveillance; however, the blocking of viral transmission to susceptible populations (neighbors or family) from all of the viremic travelers, including those with or without symptoms, is critical to prevent

Incidence and Clinical Features of Respiratory Syncytial Virus Infections in a Population-Based Surveillance Site in the Nile Delta Region

DTIC Science & Technology

2013-01-01

S U P P L E M E N T A R T I C L E Incidence and Clinical Features of Respiratory Syncytial Virus Infections in a Population-Based Surveillance Site...19a. NAME OF RESPONSIBLE PERSON a. REPORT unclassified b. ABSTRACT unclassified c . THIS PAGE unclassified Standard Form 298 (Rev. 8-98...Patients of any age were eligible if they presented with ≥1 sign of acute infection, (docu- mented fever ≥38° C or history of subjective fever with

Salmonella infections in food workers identified through routine Public Health Surveillance in Minnesota: impact on outbreak recognition.

PubMed

Medus, Carlota; Smith, Kirk E; Bender, Jeffrey B; Leano, Fe; Hedberg, Craig W

2010-11-01

The frequency of Salmonella-infected food workers identified through routine surveillance from 1997 to 2004 in Minnesota was determined in order to evaluate the impact of surveillance on the detection of outbreaks in restaurants and to quantify the duration of Salmonella shedding in stool. Of 4,976 culture-confirmed Salmonella cases reported to the Minnesota Department of Health, 110 (2.2%) were identified as food workers; this was less than one-half the number expected based on the incidence of Salmonella in the general population. Twenty food workers (18%) were associated with outbreaks. Twelve were involved in nine independent outbreaks at the restaurants where they worked. The identification of the index food worker in six of these outbreaks was critical to the initiation of outbreak investigations that revealed much larger problems. Among food workers who submitted specimens until at least one negative result was obtained (n = 69), the median duration of shedding was 22 days (range, 1 to 359 days). Among the four most common serotypes (Enteritidis, Typhimurium, Heidelberg, and Newport) the median duration of shedding was significantly longer for Salmonella Newport (80 days; P = 0.02) and for Salmonella Enteritidis (32 days; P = 0.04) than for Salmonella Heidelberg (8 days). Food workers should be considered an important source of Salmonella transmission, and those identified through surveillance should raise a high index of suspicion of a possible outbreak at their place of work. Food service managers need to be alert to Salmonella-like illnesses among food workers to facilitate prevention and control efforts, including exclusion of infected food workers or restriction of their duties.

A reliable user authentication and key agreement scheme for Web-based Hospital-acquired Infection Surveillance Information System.

PubMed

Wu, Zhen-Yu; Tseng, Yi-Ju; Chung, Yufang; Chen, Yee-Chun; Lai, Feipei

2012-08-01

With the rapid development of the Internet, both digitization and electronic orientation are required on various applications in the daily life. For hospital-acquired infection control, a Web-based Hospital-acquired Infection Surveillance System was implemented. Clinical data from different hospitals and systems were collected and analyzed. The hospital-acquired infection screening rules in this system utilized this information to detect different patterns of defined hospital-acquired infection. Moreover, these data were integrated into the user interface of a signal entry point to assist physicians and healthcare providers in making decisions. Based on Service-Oriented Architecture, web-service techniques which were suitable for integrating heterogeneous platforms, protocols, and applications, were used. In summary, this system simplifies the workflow of hospital infection control and improves the healthcare quality. However, it is probable for attackers to intercept the process of data transmission or access to the user interface. To tackle the illegal access and to prevent the information from being stolen during transmission over the insecure Internet, a password-based user authentication scheme is proposed for information integrity.

Effect of intrapartum antibiotic prophylaxis against group B streptococcal infection on comparisons of rates of endometritis and urinary tract infection in multicenter surveillance.

PubMed

Dumas, Anne-Marie; Girard, Raphaëlle; Ayzac, Louis; Beaumont, Geneviève; Caillat-Vallet, Emmanuelle; Depaix, Florence; Gignoux, Chantal; Haond, Catherine; Pral, Noelle; Robert, Jacqueline; Tissot-Guerraz, Françoise; Vincent-Bouletreau, Agnès; Berland, Michel; Fabry, Jacques

2008-04-01

To establish whether antibiotic prophylaxis against group B streptococcal infection may be a confounding factor in comparisons of rates of endometritis and urinary tract infection after vaginal delivery. Prospective study. Maternity units at 48 hospitals in a regional surveillance network in France during 2001-2004. The maternity units used a common protocol to establish whether antibiotic prophylaxis was indicated. Risk factors for endometritis and urinary tract infections were evaluated using multiple logistic regression. We analyzed 49,786 vaginal deliveries. The percentage of women receiving antibiotic prophylaxis varied widely and significantly among the maternity units (range, 4.4%-26.0%; median, 15.8%; 25th percentile, 12.1%; 75th percentile, 19.0%) (P < .001, by Mantel-Haenszel chi(2) test). The incidence rate of endometritis was significantly reduced from 0.25% to 0.11% by antibiotic prophylaxis (P = .001). There was a decrease in the incidence of urinary tract infection from 0.37% to 0.32%, but it was not statistically significant (P = .251). A reduction in the incidence of endometritis was observed when intrapartum antibiotic prophylaxis against group B streptococcal infection was used. However, the proportion of women considered to be at risk of infection varied widely among institutions. Comparisons of rates of endometritis among maternity units, but not urinary tract infection rates, should take into account antibiotic prophylaxis as a significant confounding factor.

[NEOCAT, surveillance network of catheter-related bloodstream infections in neonates: 2010 data].

PubMed

L'Hériteau, F; Lacavé, L; Leboucher, B; Decousser, J-W; De Chillaz, C; Astagneau, P; Aujard, Y

2012-09-01

The NEOCAT surveillance network was implemented in 2006 in order to address catheter-associated bloodstream infections (BSIs) in neonates. The results for 2010 surveillance are presented herein. Neonatal intensive care units (NICUs) participated in the study on a voluntary basis. Umbilical catheters (UCs) and central venous catheters (CVCs) were analyzed separately. In 2010, 26NICUs participated. Overall, 2953 neonates were included (median weight, 1550 g; median gestational age, 32 weeks). These neonates had 2551UCs (median insertion duration, 4 days) and 2147CVCs (median insertion duration, 12 days). Thirty-three BSIs associated with UCs were reported, yielding a 2.9/1000UC-day incidence density, 95% confidence interval (95%CI) (1.9-3.8). UC-associated BSIs appeared after a median period of 5 days after UC insertion. The main microorganism isolated from blood cultures was coagulase negative staphylococci (CNS, n=27), S. aureus (n=3), and Enterobacteriaceae (n=5). Three hundred and six CVC-associated BSIs were recorded, yielding a 11.2/1000 CVC-day incidence density (95%CI, 10.0-12.5). These BSIs occurred after a median period of 12 days after CVC insertion. The main microorganisms were CNS (83%), S. aureus (6%), and Enterobacteriaceae (5%). The NEOCAT network provides a useful benchmark for participating wards. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

[Audit of preoperative antibiotic prophylaxis in a surgical site infections surveillance network].

PubMed

Rioux, C; Blanchon, T; Golliot, F; Berrouane, Y; Chalfine, A; Costa, Y; Laisné, M J; Levy, S; Richard, L; Seguier, J C; Botherel, A H; Astagneau, P

2002-10-01

To evaluate the preoperative antibiotic prophylaxis (PAP) prescriptions in a surgical site infection (SSI) surveillance network. Auto-evaluative audit in a prospective multicenter cohort included in a surveillance system. Since 1997, surgical wards in volunteer centers monitored all surgery patients each year during a period of two months. Patients were evaluated for SSI during the 30 days following surgery. Participating centers were asked in 2000 to participate to a PAP practice assessment. For each surgery patient, a questionnaire was completed. The "Guidelines for Antibiotic Prophylaxis Prescription in Surgery" edited in 1999 by the Société française d'anesthésie et de réanimation was used as gold standard. 6109 patients were included in the survey from 34 health care centers and 3881 received PAP. 90% of patients received PAP intravenously and 63% received twice the curative dose. PAP was administered within 90 minutes prior to incision in 70% of cases. 78% of PAP lasted less than 24 hours. PAP indication with regards to the type of surgical procedures was assessed in 4629 patients. PAP guidelines were observed in 1573 (34%) patients: 999 patients in whom PAP was not indicated did not receive PAP and 574 received it in compliance with recommended dose and indications. Efforts should be made to improve PAP prescription according to standards guidelines.

Healthcare-associated infections in pediatric cancer patients: results of a prospective surveillance study from university hospitals in Germany and Switzerland.

PubMed

Simon, Arne; Ammann, Roland A; Bode, Udo; Fleischhack, Gudrun; Wenchel, Hans-Martin; Schwamborn, Dorothee; Gravou, Chara; Schlegel, Paul-Gerhardt; Rutkowski, Stefan; Dannenberg, Claudia; Körholz, Dieter; Laws, Hans Jürgen; Kramer, Michael H

2008-05-23

Pediatric cancer patients face an increased risk of healthcare-associated infection (HAI). To date, no prospective multicenter studies have been published on this topic. Prospective multicenter surveillance for HAI and nosocomial fever of unknown origin (nFUO) with specific case definitions and standardized surveillance methods. 7 pediatric oncology centers (university facilities) participated from April 01, 2001 to August 31, 2005. During 54,824 days of inpatient surveillance, 727 HAIs and nFUOs were registered in 411 patients. Of these, 263 (36%) were HAIs in 181 patients, for an incidence density (ID) (number of events per 1,000 inpatient days) of 4.8 (95% CI 4.2 to 5.4; range 2.4 to 11.7; P < 0.001), and 464 (64%) were nFUO in 230 patients. Neutropenia at diagnosis correlated significantly with clinical severity of HAI. Of the 263 HAIs, 153 (58%) were bloodstream infections (BSI). Of the 138 laboratory-confirmed BSIs, 123 (89%) were associated with use of a long-term central venous catheter (CVAD), resulting in an overall ID of 2.8 per 1,000 utilization days (95% CI 2.3 to 3.3). The ID was significantly lower in Port-type than in Hickman-type CVADs. The death of 8 children was related to HAI, including six cases of aspergillosis. The attributable mortality was 3.0% without a significant association to neutropenia at time of NI diagnosis. Our study confirmed that pediatric cancer patients are at an increased risk for specific HAIs. The prospective surveillance of HAI and comparison with cumulative multicenter results are indispensable for targeted prevention of these adverse events of anticancer treatment.

Understanding the Islamic Movement of Uzbekistan Through Social Movement Theory, and Analyzing and Evaluating Its Potential Threat to Kazakhstan

DTIC Science & Technology

2014-12-01

ORGANIZATION REPORT NUMBER 9. SPONSORING /MONITORING AGENCY NAME(S) AND ADDRESS(ES) N /A 10. SPONSORING/MONITORING AGENCY REPORT NUMBER...Insurgency, 1930‒1970 (Chicago: University of Chicago Press, 1982), 18. 36 Doug McAdam, John D. McCarthy, and Mayer N . Zald, Comparative Perspectives on...Portrait,” Central Asia and the Caucasus, http://cyberleninka.ru/article/ n /the-islamic-movement-of-uzbekistan-lines-to- complete-the-portrait. 27

Surgical site infections following coronary artery bypass graft procedures: 10 years of surveillance data.

PubMed

Si, Damin; Rajmokan, Mohana; Lakhan, Prabha; Marquess, John; Coulter, Christopher; Paterson, David

2014-06-10

Surgical site infections following coronary artery bypass graft (CABG) procedures pose substantial burden on patients and healthcare systems. This study aims to describe the incidence of surgical site infections and causative pathogens following CABG surgery over the period 2003-2012, and to identify risk factors for complex sternal site infections. Routine computerised surveillance data were collected from three public hospitals in Queensland, Australia in which CABG surgery was performed between 2003 and 2012. Surgical site infection rates were calculated by types of infection (superficial/complex) and incision sites (sternal/harvest sites). Patient and procedural characteristics were evaluated as risk factors for complex sternal site infections using a logistic regression model. There were 1,702 surgical site infections (518 at sternal sites and 1,184 at harvest sites) following 14,546 CABG procedures performed. Among 732 pathogens isolated, Methicillin-sensitive Staphylococcus aureus accounted for 28.3% of the isolates, Pseudomonas aeruginosa 18.3%, methicillin-resistant Staphylococcus aureus 14.6%, and Enterobacter species 6.7%. Proportions of Gram-negative bacteria elevated from 37.8% in 2003 to 61.8% in 2009, followed by a reduction to 42.4% in 2012. Crude rates of complex sternal site infections increased over the reporting period, ranging from 0.7% in 2004 to 2.6% in 2011. Two factors associated with increased risk of complex sternal site infections were identified: patients with an ASA (American Society of Anaesthesiologists) score of 4 or 5 (reference score of 3, OR 1.83, 95% CI 1.36-2.47) and absence of documentation of antibiotic prophylaxis (OR 2.03, 95% CI 1.12-3.69). Compared with previous studies, our data indicate the importance of Gram-negative organisms as causative agents for surgical site infections following CABG surgery. An increase in complex sternal site infection rates can be partially explained by the increasing proportion of patients

Nosocomial infections in geriatric long-term-care and rehabilitation facilities: exploration in the development of a risk index for epidemiological surveillance.

PubMed

Golliot, F; Astagneau, P; Cassou, B; Okra, N; Rothan-Tondeur, M; Brücker, G

2001-12-01

To compute a risk index for nosocomial infection (NI) surveillance in geriatric long-term-care facilities (LTCFs) and rehabilitation facilities. Analysis of data collected during the French national prevalence survey on NIs conducted in 1996. Risk indices were constructed based on the patient case-mix defined according to risk factors for NIs identified in the elderly. 248 geriatric units in 77 hospitals located in northern France. All hospital inpatients on the day of the survey were included. Data from 11,254 patients were recorded. The overall rate of infected patients was 9.9%. Urinary tract, respiratory tract, and skin were the most common infection sites in both rehabilitation facilities and LTCFs. Eleven risk indices, categorizing patients in 3 to 7 levels of increasing NI risk, ranging from 2.7% to 36.2%, were obtained. Indices offered risk adjustment according to NI rate stratification and clinical relevance of risk factors such as indwelling devices, open bedsores, swallowing disorders, sphincter incontinence, lack of mobility, immunodeficiency, or rehabilitation activity. The optimal index should be tailored to the strategy selected for NI surveillance in geriatric facilities in view of available financial and human resources.

A Serological Protein Microarray for Detection of Multiple Cross-Reactive Flavivirus Infections in Horses for Veterinary and Public Health Surveillance.

PubMed

Cleton, N B; van Maanen, K; Bergervoet, S A; Bon, N; Beck, C; Godeke, G-J; Lecollinet, S; Bowen, R; Lelli, D; Nowotny, N; Koopmans, M P G; Reusken, C B E M

2017-12-01

The genus Flavivirus in the family Flaviviridae includes some of the most important examples of emerging zoonotic arboviruses that are rapidly spreading across the globe. Japanese encephalitis virus (JEV), West Nile virus (WNV), St. Louis encephalitis virus (SLEV) and Usutu virus (USUV) are mosquito-borne members of the JEV serological group. Although most infections in humans are asymptomatic or present with mild flu-like symptoms, clinical manifestations of JEV, WNV, SLEV, USUV and tick-borne encephalitis virus (TBEV) can include severe neurological disease and death. In horses, infection with WNV and JEV can lead to severe neurological disease and death, while USUV, SLEV and TBEV infections are mainly asymptomatic, however, and induce antibody responses. Horses often serve as sentinels to monitor active virus circulation in serological surveillance programmes specifically for WNV, USUV and JEV. Here, we developed and validated a NS1-antigen protein microarray for the serological differential diagnosis of flavivirus infections in horses using sera of experimentally and naturally infected symptomatic as well as asymptomatic horses. Using samples from experimentally infected horses, an IgG and IgM specificity of 100% and a sensitivity of 95% for WNV and 100% for JEV was achieved with a cut-off titre of 1 : 20 based on ROC calculation. In field settings, the microarray identified 93-100% of IgG-positive horses with recent WNV infections and 87% of TBEV IgG-positive horses. WNV IgM sensitivity was 80%. Differentiation between closely related flaviviruses by the NS1-antigen protein microarray is possible, even though we identified some instances of cross-reactivity among antibodies. However, the assay is not able to differentiate between naturally infected horses and animals vaccinated with an inactivated WNV whole-virus vaccine. We showed that the NS1-microarray can potentially be used for diagnosing and distinguishing flavivirus infections in horses and for public

In vitro echinocandin susceptibility of Aspergillus isolates from patients enrolled in the Transplant-Associated Infection Surveillance Network.

PubMed

Lockhart, Shawn R; Zimbeck, Alicia J; Baddley, John W; Marr, Kieren A; Andes, David R; Walsh, Thomas J; Kauffman, Carol A; Kontoyiannis, Dimitrios P; Ito, James I; Pappas, Peter G; Chiller, Tom

2011-08-01

We determined the echinocandin minimum effective concentration (MEC) values for caspofungin, micafungin, and anidulafungin against 288 Aspergillus isolates prospectively collected from transplant patients with proven or probable invasive aspergillosis between 2001 and 2006 as part of the Transplant-Associated Infection Surveillance Network (TRANSNET). We demonstrated that the vast majority of Aspergillus isolates had MEC values at or below the epidemiological cutoff values for caspofungin, micafungin, and anidulafungin, including those from patients who had received caspofungin.

Intensive care unit surveillance of influenza infection in France: the 2009/10 pandemic and the three subsequent seasons.

PubMed

Bonmarin, Isabelle; Belchior, Emmanuel; Bergounioux, Jean; Brun-Buisson, Christian; Mégarbane, Bruno; Chappert, Jean Loup; Hubert, Bruno; Le Strat, Yann; Lévy-Bruhl, Daniel

2015-01-01

During the 2009/10 pandemic, a national surveillance system for severe influenza cases was set up in France. We present results from the system's first four years. All severe influenza cases admitted to intensive care units (ICU) were reported to the Institut de Veille Sanitaire using a standardised form: data on demographics, immunisation and virological status, risk factors, severity (e.g. acute respiratory distress syndrome (ARDS) onset, mechanical ventilation, extracorporeal life support) and outcome. Multivariate analysis was performed to identify factors associated with ARDS and death. The number of confirmed influenza cases varied from 1,210 in 2009/10 to 321 in 2011/12. Most ICU patients were infected with A(H1N1)pdm09, except during the 2011/12 winter season when A(H3N2)-related infections predominated. Patients' characteristics varied according to the predominant strain. Based on multivariate analysis, risk factors associated with death were age ≥ 65 years, patients with any of the usual recommended indications for vaccination and clinical severity. ARDS occurred more frequently in patients who were middle-aged (36-55 years), pregnant, obese, or infected with A(H1N1)pdm09. Female sex and influenza vaccination were protective. These data confirm the persistent virulence of A(H1N1)pdm09 after the pandemic and the heterogeneity of influenza seasons, and reinforce the need for surveillance of severe influenza cases.

Paleosoils in the loess deposits of eastern Uzbekistan

NASA Astrophysics Data System (ADS)

Abdunazarov, U. K.; Stelmakh, A. G.

2010-12-01

Loess deposits of the eastern Uzbekistan are difficult to study the stratigraphy of the object. Clarification of the relationship of age and genetic features of the considered entities by traditional methods is difficult due to scarcity of remnants of the fauna and flora, the active Quaternary tectonics, the homogeneity of the rocks, especially the formation of loess sequences, specific conditions of geological and tectonic development, etc. In this regard, particularly relevant is the study of loess deposits by paleosoils subdivision and correlation. Paleosoils, which are present in the sections of loess sequences, distinct from loess-like loams, dividing them among themselves. Color these paleosoils noticeable brownish or brown, while the loess is a powdery mildew gray rock. Typically, the general scheme of occurrence of loess cover is linked with levels of relief mountainous areas. Recent studies show that the loess in the piedmont plains overlie a complex manner and include uneven paleosoils. Therefore, loess sequences of different geomorphological levels from the lower parts of slopes to the watershed have been studied in research paleosoils. The scheme was drawn up as a result of the studies. This scheme shows the main horizons paleosoils in loess deposits. Even-aged paleosoils and share their loess were identified in this scheme.

Expanding severe acute respiratory infection (SARI) surveillance beyond influenza: The process and data from 1 year of implementation in Vietnam.

PubMed

Alroy, Karen A; Do, Trang Thuy; Tran, Phu Dac; Dang, Tan Quang; Vu, Long Ngoc; Le, Nga Thi Hang; Dang, Anh Duc; Ngu, Nghia Duy; Ngo, Tu Huy; Hoang, Phuong Vu Mai; Phan, Lan Trong; Nguyen, Thuong Vu; Nguyen, Long Thanh; Nguyen, Thinh Viet; Vien, Mai Quang; Le, Huy Xuan; Dao, Anh The; Nguyen, Trieu Bao; Pham, Duoc Tho; Nguyen, Van Thi Tuyet; Pham, Thanh Ngoc; Phan, Binh Hai; Whitaker, Brett; Do, Thuy Thi Thu; Dao, Phuong Anh; Balajee, S Arunmozhi; Mounts, Anthony W

2018-05-13

In 2016, as a component of the Global Health Security Agenda, the Vietnam Ministry of Health expanded its existing influenza sentinel surveillance for severe acute respiratory infections (SARI) to include testing for 7 additional viral respiratory pathogens. This article describes the steps taken to implement expanded SARI surveillance in Vietnam and reports data from 1 year of expanded surveillance. The process of expanding the suite of pathogens for routine testing by real-time reverse transcriptase-polymerase chain reaction (rRT-PCR) included laboratory trainings, procurement/distribution of reagents, and strengthening and aligning SARI surveillance epidemiology practices at sentinel sites and regional institutes (RI). Surveillance data showed that of 4003 specimens tested by the RI laboratories, 20.2% (n = 810) were positive for influenza virus. Of the 3193 influenza-negative specimens, 41.8% (n = 1337) were positive for at least 1 non-influenza respiratory virus, of which 16.2% (n = 518), 13.4% (n = 428), and 9.6% (n = 308) tested positive for respiratory syncytial virus, rhinovirus, and adenovirus, respectively. The Government of Vietnam has demonstrated that expanding respiratory viral surveillance by strengthening and building upon an influenza platform is feasible, efficient, and practical. © 2018 The Authors. Influenza and Other Respiratory Viruses Published by John Wiley & Sons Ltd.

Results of Four-Year Rectal Vancomycin-Resistant Enterococci Surveillance in a Pediatric Hematology-Oncology Ward: From Colonization to Infection.

PubMed

Aktürk, Hacer; Sütçü, Murat; Somer, Ayper; Karaman, Serap; Acar, Manolya; Ünüvar, Ayşegül; Anak, Sema; Karakaş, Zeynep; Özdemir, Aslı; Sarsar, Kutay; Aydın, Derya; Salman, Nuran

2016-09-05

To investigate the clinical impact of vancomycin-resistant enterococci (VRE) colonization in patients with hematologic malignancies and associated risk factors. Patients colonized and infected with VRE were identified from an institutional surveillance database between January 2010 and December 2013. A retrospective case-control study was performed to identify the risk factors associated with development of VRE infection in VRE-colonized patients. Fecal VRE colonization was documented in 72 of 229 children (31.4%). Seven VRE-colonized patients developed subsequent systemic VRE infection (9.7%). Types of VRE infections included bacteremia (n=5), urinary tract infection (n=1), and meningitis (n=1). Enterococcus faecium was isolated in all VRE infections. Multivariate analysis revealed severe neutropenia and previous bacteremia with another pathogen as independent risk factors for VRE infection development in colonized patients [odds ratio (OR): 35.4, confidence interval (CI): 1.7-72.3, p=0.02 and OR: 20.6, CI: 1.3-48.6, p=0.03, respectively]. No deaths attributable to VRE occurred. VRE colonization has important consequences in pediatric cancer patients.

Evaluation of the novel respiratory virus surveillance program: Pediatric Early Warning Sentinel Surveillance (PEWSS).

PubMed

Armour, Patricia A; Nguyen, Linh M; Lutman, Michelle L; Middaugh, John P

2013-01-01

Infections caused by respiratory viruses are associated with recurrent epidemics and widespread morbidity and mortality. Routine surveillance of these pathogens is necessary to determine virus activity, monitor for changes in circulating strains, and plan for public health preparedness. The Southern Nevada Health District in Las Vegas, Nevada, recruited five pediatric medical practices to serve as sentinel sites for the Pediatric Early Warning Sentinel Surveillance (PEWSS) program. Sentinel staff collected specimens throughout the year from ill children who met the influenza-like illness case definition and submitted specimens to the Southern Nevada Public Health Laboratory for molecular testing for influenza and six non-influenza viruses. Laboratory results were analyzed and reported to the medical and general communities in weekly bulletins year-round. PEWSS data were also used to establish viral respiratory seasonal baselines and in influenza vaccination campaigns. The surveillance program was evaluated using the Centers for Disease Control and Prevention's (CDC's) Updated Guidelines for Evaluating Public Health Surveillance Systems. PEWSS met three of six program usefulness criteria and seven of nine surveillance system attributes, which exceeded the CDC Guidelines evaluation criteria for a useful and complete public health surveillance program. We found that PEWSS is a useful and complete public health surveillance system that is simple, flexible, accessible, and stable.

Surveillance for Chikungunya and Dengue During the First Year of Chikungunya Virus Circulation in Puerto Rico

PubMed Central

Sharp, Tyler M.; Ryff, Kyle R.; Alvarado, Luisa; Shieh, Wun-Ju; Zaki, Sherif R.; Margolis, Harold S.; Rivera-Garcia, Brenda

2016-01-01

After chikungunya virus (CHIKV) transmission was detected in Puerto Rico in May 2014, multiple surveillance systems were used to describe epidemiologic trends and CHIKV-associated disease. Of 28 327 cases reported via passive surveillance, 6472 were tested for evidence of CHIKV infection, and results for 4399 (68%) were positive. Of 250 participants in household cluster investigations, 70 (28%) had evidence of recent CHIKV infection. Enhanced surveillance for chikungunya at 2 hospitals identified 1566 patients who tested positive for CHIKV, of whom 10.9% were hospitalized. Enhanced surveillance for fatal cases enabled identification of 31 cases in which CHIKV was detected in blood or tissue specimens. All surveillance systems detected a peak incidence of chikungunya in September 2014 and continued circulation in 2015. Concomitant surveillance for dengue demonstrated low incidence, which had decreased before CHIKV was introduced. Multifaceted chikungunya surveillance in Puerto Rico resolved gaps in traditional passive surveillance and enabled a holistic description of the spectrum of disease associated with CHIKV infection. PMID:27920177

Linking HIV and antiretroviral drug resistance surveillance in Peru: a model for a third-generation HIV sentinel surveillance.

PubMed

Lama, Javier R; Sanchez, Jorge; Suarez, Luis; Caballero, Patricia; Laguna, Alberto; Sanchez, Jose L; Whittington, William L H; Celum, Connie; Grant, Robert M

2006-08-01

HIV drug resistance surveillance is limited by recruitment and selection bias and by limited information regarding HIV incidence rates, secondary resistance, and treatment prevalence. A second-generation HIV sentinel surveillance among men who have sex with men (MSM), regardless of prior history of HIV screening, serostatus, or treatment, was conducted in Peru in 2002. Recent HIV infection was estimated using sensitive/less sensitive enzyme immunoassay testing. Genotypic resistance testing was performed. HIV prevalence was 13.9% (456 HIV positive of 3280 participants). HIV incidence was estimated to be 5.1 per 100 person-years (95% confidence interval: 3.1-8.3). Among 143 MSM who were aware of their HIV infection before testing, only 20 (14.0%) were receiving antiretrovirals (ARV). Mutations conferring ARV resistance were found in 12 (3.3%) of 359 treatment-naive and 5 (31.3%) of 16 treatment-experienced participants with successful genotyping. One recently infected man from Lima demonstrated 3-class multidrug resistance. The most frequently observed mutations in treatment-naive, chronically infected persons from Lima were M184V (1.7%), D30N (1.3%), L90M (1.3%), and L10I (1.3%). The prevalence of ARV resistance among treatment-naive MSM in Peru is low, reflecting limited access to treatment before 2004, and contrasts with the history of ARV treatment in developed countries, where high levels of nucleoside reverse transcriptase inhibitor resistance occurred before introduction of highly active antiretroviral therapy. Linking ARV resistance and HIV sentinel surveillance in developing settings is feasible and should be considered in third-generation HIV sentinel surveillance programs.

Global Surveillance of Emerging Influenza Virus Genotypes by Mass Spectrometry

DTIC Science & Technology

2007-05-30

Intercontinental circulation of human influenza A( H1N2 ) reassortant viruses during the 2001–2002 influenza season. J Infect Dis 186: 1490–1493. 6. Taubenberger...Global Surveillance of Emerging Influenza Virus Genotypes by Mass Spectrometry Rangarajan Sampath1*, Kevin L. Russell2, Christian Massire1, Mark W...Infections and Immunity, University of Texas Medical Branch, Galveston, Texas, United States of America Background. Effective influenza surveillance requires

Real-time PCR as a surveillance tool for the detection of Trichinella infection in muscle samples from wildlife.

PubMed

Cuttell, Leigh; Corley, Sean W; Gray, Christian P; Vanderlinde, Paul B; Jackson, Louise A; Traub, Rebecca J

2012-09-10

Trichinella nematodes are the causative agent of trichinellosis, a meat-borne zoonosis acquired by consuming undercooked, infected meat. Although most human infections are sourced from the domestic environment, the majority of Trichinella parasites circulate in the natural environment in carnivorous and scavenging wildlife. Surveillance using reliable and accurate diagnostic tools to detect Trichinella parasites in wildlife hosts is necessary to evaluate the prevalence and risk of transmission from wildlife to humans. Real-time PCR assays have previously been developed for the detection of European Trichinella species in commercial pork and wild fox muscle samples. We have expanded on the use of real-time PCR in Trichinella detection by developing an improved extraction method and SYBR green assay that detects all known Trichinella species in muscle samples from a greater variety of wildlife. We simulated low-level Trichinella infections in wild pig, fox, saltwater crocodile, wild cat and a native Australian marsupial using Trichinella pseudospiralis or Trichinella papuae ethanol-fixed larvae. Trichinella-specific primers targeted a conserved region of the small subunit of the ribosomal RNA and were tested for specificity against host and other parasite genomic DNAs. The analytical sensitivity of the assay was at least 100 fg using pure genomic T. pseudospiralis DNA serially diluted in water. The diagnostic sensitivity of the assay was evaluated by spiking 10 g of each host muscle with T. pseudospiralis or T. papuae larvae at representative infections of 1.0, 0.5 and 0.1 larvae per gram, and shown to detect larvae at the lowest infection rate. A field sample evaluation on naturally infected muscle samples of wild pigs and Tasmanian devils showed complete agreement with the EU reference artificial digestion method (k-value=1.00). Positive amplification of mouse tissue experimentally infected with T. spiralis indicated the assay could also be used on encapsulated

Second-generation HIV surveillance: better data for decision-making.

PubMed Central

Rehle, Thomas; Lazzari, Stefano; Dallabetta, Gina; Asamoah-Odei, Emil

2004-01-01

This paper seeks to outline the key elements of the expanded surveillance efforts recommended by the second-generation HIV surveillance approach. Second-generation systems focus on improving and expanding existing surveillance methods and combine them in ways that have the greatest explanatory power. The main elements of this approach include: considering biological surveillance - HIV, AIDS, sexually transmitted infections (STIs) - and behavioural surveillance as integral components, targeting surveillance efforts at segments of the population where most new infections are concentrated - which might differ depending on the stage and type of the epidemic - and providing the rationale for the optimal use of data generated for monitoring the HIV epidemic and evaluating national AIDS control programmes. The paper emphasizes improvements in existing surveillance methodologies and discusses in detail crucial issues such as the validity of HIV prevalence data measured in pregnant women and linking HIV surveillance and behavioural data collection. In addition, a strategic partnership between second-generation surveillance and AIDS programme evaluation is proposed that stresses the complementary roles of these data collection activities in determining the effectiveness of prevention and care programmes and explaining the epidemiological trend data collected by sentinel serosurveillance systems. In conclusion, second-generation HIV surveillance systems provide a comprehensive, cost-effective and appropriate response to the information needs of AIDS control programmes. The implementation of such systems, including a better use of the data generated by the system, will ensure that national programmes are in the best possible position to respond to the challenges of the epidemic. PMID:15042234

Second-generation HIV surveillance: better data for decision-making.

PubMed

Rehle, Thomas; Lazzari, Stefano; Dallabetta, Gina; Asamoah-Odei, Emil

2004-02-01

This paper seeks to outline the key elements of the expanded surveillance efforts recommended by the second-generation HIV surveillance approach. Second-generation systems focus on improving and expanding existing surveillance methods and combine them in ways that have the greatest explanatory power. The main elements of this approach include: considering biological surveillance - HIV, AIDS, sexually transmitted infections (STIs) - and behavioural surveillance as integral components, targeting surveillance efforts at segments of the population where most new infections are concentrated - which might differ depending on the stage and type of the epidemic - and providing the rationale for the optimal use of data generated for monitoring the HIV epidemic and evaluating national AIDS control programmes. The paper emphasizes improvements in existing surveillance methodologies and discusses in detail crucial issues such as the validity of HIV prevalence data measured in pregnant women and linking HIV surveillance and behavioural data collection. In addition, a strategic partnership between second-generation surveillance and AIDS programme evaluation is proposed that stresses the complementary roles of these data collection activities in determining the effectiveness of prevention and care programmes and explaining the epidemiological trend data collected by sentinel serosurveillance systems. In conclusion, second-generation HIV surveillance systems provide a comprehensive, cost-effective and appropriate response to the information needs of AIDS control programmes. The implementation of such systems, including a better use of the data generated by the system, will ensure that national programmes are in the best possible position to respond to the challenges of the epidemic.

Twenty Years of Active Bacterial Core Surveillance

PubMed Central

Schaffner, William; Farley, Monica M.; Lynfield, Ruth; Bennett, Nancy M.; Reingold, Arthur; Thomas, Ann; Harrison, Lee H.; Nichols, Megin; Petit, Susan; Miller, Lisa; Moore, Matthew R.; Schrag, Stephanie J.; Lessa, Fernanda C.; Skoff, Tami H.; MacNeil, Jessica R.; Briere, Elizabeth C.; Weston, Emily J.; Van Beneden, Chris

2015-01-01

Active Bacterial Core surveillance (ABCs) was established in 1995 as part of the Centers for Disease Control and Prevention Emerging Infections Program (EIP) network to assess the extent of invasive bacterial infections of public health importance. ABCs is distinctive among surveillance systems because of its large, population-based, geographically diverse catchment area; active laboratory-based identification of cases to ensure complete case capture; detailed collection of epidemiologic information paired with laboratory isolates; infrastructure that allows for more in-depth investigations; and sustained commitment of public health, academic, and clinical partners to maintain the system. ABCs has directly affected public health policies and practices through the development and evaluation of vaccines and other prevention strategies, the monitoring of antimicrobial drug resistance, and the response to public health emergencies and other emerging infections. PMID:26292067

Preventing the next 'SARS' - European healthcare workers' attitudes towards monitoring their health for the surveillance of newly emerging infections: qualitative study

PubMed Central

2011-01-01

Background Hospitals are often the epicentres of newly circulating infections. Healthcare workers (HCWs) are at high risk of acquiring infectious diseases and may be among the first to contract emerging infections. This study aims to explore European HCWs' perceptions and attitudes towards monitoring their absence and symptom reports for surveillance of newly circulating infections. Methods A qualitative study with thematic analysis was conducted using focus group methodology. Forty-nine hospital-based HCWs from 12 hospitals were recruited to six focus groups; two each in England and Hungary and one each in Germany and Greece. Results HCWs perceived risk factors for occupationally acquired infectious diseases to be 1.) exposure to patients with undiagnosed infections 2.) break-down in infection control procedures 3.) immuno-naïvety and 4.) symptomatic colleagues. They were concerned that a lack of monitoring and guidelines for infectious HCWs posed a risk to staff and patients and felt employers failed to take a positive interest in their health. Staffing demands and loss of income were noted as pressures to attend work when unwell. In the UK, Hungary and Greece participants felt monitoring staff absence and the routine disclosure of symptoms could be appropriate provided the effectiveness and efficiency of such a system were demonstrable. In Germany, legislation, privacy and confidentiality were identified as barriers. All HCWs highlighted the need for knowledge and structural improvements for timelier recognition of emerging infections. These included increased suspicion and awareness among staff and standardised, homogenous absence reporting systems. Conclusions Monitoring absence and infectious disease symptom reports among HCWs may be a feasible means of surveillance for emerging infections in some settings. A pre-requisite will be tackling the drivers for symptomatic HCWs to attend work. PMID:21740552

Airport sentinel surveillance and entry quarantine for dengue infections following a fever screening program in Taiwan

PubMed Central

2012-01-01

Background Dengue has not reached an endemic status in Taiwan; nevertheless, we have implemented a fever screening program at airports for the early detection of febrile passengers with a dengue infection. This study is intended to assess the performance of the airport screening procedures for dengue infection. Methods We analyzed data from the national surveillance system of the Taiwan Centers for Disease Control. We included the imported dengue cases reported by sentinel airports and clinics as well as the domestic cases from 2007–2010. Results Approximately 44.9% (95%CI: 35.73-54.13%) of the confirmed imported dengue cases with an apparent symptom (febrile) in the viremic stage were detected via the airport fever screening program, with an estimated positive predictive value of 2.36% (95% CI: 0.96- 3.75%) and a negative predictive value > 99.99%. Fluctuations in the number of the symptomatic imported dengue cases identified in the airports (X) were associated with the total number of imported dengue cases (Y) based on a regression analysis of a biweekly surveillance (i.e., n = 104, R2X:Y = 0.61, P < 0.005). Additionally, the fluctuating patterns in the cumulative numbers of the imported dengue cases (X) with a 1–2 month lead time (t) was in parallel with that of the domestic dengue cases (Y) based on a consecutive 4-year surveillance (i.e., n = 48, R2X(t-1):Y = 0.22, R2X(t-2):Y = 0.31, P < 0.001) from 2007–2010. Conclusions A moderate sensitivity of detecting dengue at the airports examined in this study indicated some limitations of the fever screening program for the prevention of importation. The screening program could assist in the rapid triage for self-quarantine of some symptomatic dengue cases that were in the viremic stage at the borders and contribute to active sentinel surveillance; however, the blocking of viral transmission to susceptible populations (neighbors or family) from all of the viremic travelers

Converting Mosquito Surveillance to Arbovirus Surveillance with Honey-Baited Nucleic Acid Preservation Cards.

PubMed

Flies, Emily J; Toi, Cheryl; Weinstein, Philip; Doggett, Stephen L; Williams, Craig R

2015-07-01

Spatially and temporally accurate information about infectious mosquito distribution allows for pre-emptive public health interventions that can reduce the burden of mosquito-borne infections on human populations. However, the labile nature of arboviruses, the low prevalence of infection in mosquitoes, the expensive labor costs for mosquito identification and sorting, and the specialized equipment required for arbovirus testing can obstruct arbovirus surveillance efforts. The recently developed techniques of testing mosquito expectorate using honey-baited nucleic acid preservation cards or sugar bait stations allows a sensitive method of testing for infectious, rather than infected, mosquito vectors. Here we report the results from the first large-scale incorporation of honey-baited cards into an existing mosquito surveillance program. During 4 months of the peak virus season (January-April, 2014) for a total of 577 trap nights, we set CO2-baited encephalitis vector survey (EVS) light traps at 88 locations in South Australia. The collection container for the EVS trap was modified to allow for the placement of a honey-baited nucleic acid preservation card (FTA™ card) inside. After collection, mosquitoes were maintained in a humid environment and allowed access to the cards for 1 week. Cards were then analyzed for common endemic Australian arboviruses using a nested RT-PCR. Eighteen virus detections, including 11 Ross River virus, four Barmah Forest virus, and three Stratford virus (not previously reported from South Australia) were obtained. Our findings suggest that adding FTA cards to an existing mosquito surveillance program is a rapid and efficient way of detecting infectious mosquitoes with high spatial resolution.

Laboratory-based Salmonella surveillance in Fiji, 2004-2005.

PubMed

Dunn, John; Pryor, Jan; Saketa, Salanieta; Delai, Wasale; Buadromo, Eka; Kishore, Kamal; Naidu, Shakila; Greene, Sharon; Varma, Jay; Chiller, Tom

2005-09-01

Although foodborne diseases are an important public health problem worldwide, the burden of foodborne illness is not well described in most Pacific Island Countries and Territories. Laboratory-based surveillance programs can detect trends and outbreaks, estimate burden of illness, and allow subtyping of enteric pathogens (e.g. Salmonella serotyping), which is critical for linking illness to food vehicles and animal reservoirs. To enhance public health capacity in Fiji for foodborne disease surveillance, we developed the Salmonella Surveillance Project (SSP), a collaboration to pilot laboratory-based surveillance for Salmonella. A network of national and international partners was formed including epidemiologists, microbiologists, and environmental health personnel. Ministry of Health personnel were trained in foodborne disease surveillance and outbreak investigation. Three clinical microbiology laboratories from different parts of the country functioned as sentinel sites, reporting all laboratory-confirmed Salmonella infections using a standardized case report form. Non-Typhi Salmonella isolates were collected for serotyping. In 2004-2005, 86 non-Typhi Salmonella and 275 S. Typhi laboratory-confirmed infections were reported. Salmonella enterica serotype I 3,10: r:- and Salmonella enterica serotype Weltevreden were the most commonly isolated non-Typhi serotypes. In Fiji, the SSP utilized international partnerships to facilitate training, and to enhance laboratory capacity and surveillance for salmonellosis. Incorporating laboratory-based foodborne disease reporting into national disease surveillance will enable public health officials to describe the burden of foodborne illness, identify outbreaks, conduct analytic epidemiology studies, and improve food safety.

Incidence of surgical-site infections and the validity of the National Nosocomial Infections Surveillance System risk index in a general surgical ward in Santa Cruz, Bolivia.

PubMed

Soleto, Lorena; Pirard, Marianne; Boelaert, Marleen; Peredo, Remberto; Vargas, Reinerio; Gianella, Alberto; Van der Stuyft, Patrick

2003-01-01

To estimate the frequency of and risk factors for surgical-site infections (SSIs) in Bolivia, and to study the performance of the National Nosocomial Infections Surveillance (NNIS) System risk index in a developing country. A prospective study with patient follow-up until the 30th postoperative day. A general surgical ward of a public hospital in Santa Cruz, Bolivia. Patients admitted to the ward between July 1998 and June 1999 on whom surgical procedures were performed. Follow-up was complete for 91.5% of 376 surgical procedures. The overall SSI rate was 12%. Thirty-four (75.6%) of the 45 SSIs were culture positive. A logistic regression model retained an American Society of Anesthesiologists score of more than 1 (odds ratio [OR], 1.87), a not-clean wound class (OR, 2.28), a procedure duration of more than 1 hour (OR, 1.81), and drain (OR, 1.98) as independent risk factors for SSI. There was no significant association between the NNIS System risk index and SSI rates. However, a "local" risk index constructed with the above cutoff points showed a linear trend with SSI (P < .001) and a relative risk of 3.18 for risk class 3 versus a class of less than 3. SSIs cause considerable morbidity in Santa Cruz. Appropriate nosocomial infection surveillance and control should be introduced. The NNIS System risk index did not discriminate between patients at low and high risk for SSI in this hospital setting, but a risk score based on local cutoff points performed substantially better.

Evaluation of the Novel Respiratory Virus Surveillance Program: Pediatric Early Warning Sentinel Surveillance (PEWSS)

PubMed Central

Nguyen, Linh M.; Lutman, Michelle L.; Middaugh, John P.

2013-01-01

Objectives Infections caused by respiratory viruses are associated with recurrent epidemics and widespread morbidity and mortality. Routine surveillance of these pathogens is necessary to determine virus activity, monitor for changes in circulating strains, and plan for public health preparedness. The Southern Nevada Health District in Las Vegas, Nevada, recruited five pediatric medical practices to serve as sentinel sites for the Pediatric Early Warning Sentinel Surveillance (PEWSS) program. Methods Sentinel staff collected specimens throughout the year from ill children who met the influenza-like illness case definition and submitted specimens to the Southern Nevada Public Health Laboratory for molecular testing for influenza and six non-influenza viruses. Results Laboratory results were analyzed and reported to the medical and general communities in weekly bulletins year-round. PEWSS data were also used to establish viral respiratory seasonal baselines and in influenza vaccination campaigns. The surveillance program was evaluated using the Centers for Disease Control and Prevention's (CDC's) Updated Guidelines for Evaluating Public Health Surveillance Systems. PEWSS met three of six program usefulness criteria and seven of nine surveillance system attributes, which exceeded the CDC Guidelines evaluation criteria for a useful and complete public health surveillance program. Conclusion We found that PEWSS is a useful and complete public health surveillance system that is simple, flexible, accessible, and stable. PMID:23997308

The Effect of Surveillance and Appreciative Inquiry on Puerperal Infections: A Longitudinal Cohort Study in India

PubMed Central

Hussein, Julia; Ramani, K. V.; Kanguru, Lovney; Patel, Kalpesh; Bell, Jacqueline; Patel, Purvi; Walker, Leighton; Mehta, Rajesh; Mavalankar, Dileep

2014-01-01

Objective To evaluate the effects of an intervention comprising surveillance and an organisational change called Appreciative Inquiry on puerperal infections in hospitals in Gujarat state, India. Methods This longitudinal cohort study with a control group was conducted over 16 months between 2010 and 2012. Women who delivered in six hospitals were followed-up. After a five month pre-intervention period, the intervention was introduced in three hospitals. Monthly incidence of puerperal infection was recorded throughout the study in all six hospitals. A chi-square test and logistic regression were used to examine for associations, trends and interactions between the intervention and control groups. Findings Of the 8,124 women followed up, puerperal infections were reported in 319 women (3.9%) over the course of the study. Puerperal sepsis/genital tract infections and urinary tract infections were the two most common puerperal infections. At the end of the study, infection incidence in the control group halved from 7.4% to 3.5%. Levels in the intervention group reduced proportionately even more, from 4.3% to 1.7%. A chi-square test for trend confirmed the reduction of infection in the intervention and control groups (p<0.0001) but the trends were not statistically different from one another. There was an overall reduction of infection by month (OR = 0.94 95% CI 0.91–0.97). Risk factors like delivery type, complications or delivery attendant showed no association with infection. Conclusion Interruption of resource flows in the health system occurred during the intervention phase, which may have affected the findings. The incidence of infection fell in both control and intervention groups during the course of the study. It is not clear if appreciative inquiry contributed to the reductions observed. A number of practical and methodological limitations were faced. Trial Registration Controlled-Trials.com ISRCTN03513186 PMID:24498089

Sensitivity of Bovine Tuberculosis Surveillance in Wildlife in France: A Scenario Tree Approach

PubMed Central

Rivière, Julie

2015-01-01

Bovine tuberculosis (bTB) is a common disease in cattle and wildlife, with an impact on animal and human health, and economic implications. Infected wild animals have been detected in some European countries, and bTB reservoirs in wildlife have been identified, potentially hindering the eradication of bTB from cattle populations. However, the surveillance of bTB in wildlife involves several practical difficulties and is not currently covered by EU legislation. We report here the first assessment of the sensitivity of the bTB surveillance system for free-ranging wildlife launched in France in 2011 (the Sylvatub system), based on scenario tree modelling. Three surveillance system components were identified: (i) passive scanning surveillance for hunted wild boar, red deer and roe deer, based on carcass examination, (ii) passive surveillance on animals found dead, moribund or with abnormal behaviour, for wild boar, red deer, roe deer and badger and (iii) active surveillance for wild boar and badger. The application of these three surveillance system components depends on the geographic risk of bTB infection in wildlife, which in turn depends on the prevalence of bTB in cattle. We estimated the effectiveness of the three components of the Sylvatub surveillance system quantitatively, for each species separately. Active surveillance and passive scanning surveillance by carcass examination were the approaches most likely to detect at least one infected animal in a population with a given design prevalence, regardless of the local risk level and species considered. The awareness of hunters, which depends on their training and the geographic risk, was found to affect surveillance sensitivity. The results obtained are relevant for hunters and veterinary authorities wishing to determine the actual efficacy of wildlife bTB surveillance as a function of geographic area and species, and could provide support for decision-making processes concerning the enhancement of surveillance

Sensitivity of Bovine Tuberculosis Surveillance in Wildlife in France: A Scenario Tree Approach.

PubMed

Rivière, Julie; Le Strat, Yann; Dufour, Barbara; Hendrikx, Pascal

2015-01-01

Bovine tuberculosis (bTB) is a common disease in cattle and wildlife, with an impact on animal and human health, and economic implications. Infected wild animals have been detected in some European countries, and bTB reservoirs in wildlife have been identified, potentially hindering the eradication of bTB from cattle populations. However, the surveillance of bTB in wildlife involves several practical difficulties and is not currently covered by EU legislation. We report here the first assessment of the sensitivity of the bTB surveillance system for free-ranging wildlife launched in France in 2011 (the Sylvatub system), based on scenario tree modelling. Three surveillance system components were identified: (i) passive scanning surveillance for hunted wild boar, red deer and roe deer, based on carcass examination, (ii) passive surveillance on animals found dead, moribund or with abnormal behaviour, for wild boar, red deer, roe deer and badger and (iii) active surveillance for wild boar and badger. The application of these three surveillance system components depends on the geographic risk of bTB infection in wildlife, which in turn depends on the prevalence of bTB in cattle. We estimated the effectiveness of the three components of the Sylvatub surveillance system quantitatively, for each species separately. Active surveillance and passive scanning surveillance by carcass examination were the approaches most likely to detect at least one infected animal in a population with a given design prevalence, regardless of the local risk level and species considered. The awareness of hunters, which depends on their training and the geographic risk, was found to affect surveillance sensitivity. The results obtained are relevant for hunters and veterinary authorities wishing to determine the actual efficacy of wildlife bTB surveillance as a function of geographic area and species, and could provide support for decision-making processes concerning the enhancement of surveillance

Hospital-based Clostridium difficile infection surveillance reveals high proportions of PCR ribotypes 027 and 176 in different areas of Poland, 2011 to 2013.

PubMed

Pituch, Hanna; Obuch-Woszczatyński, Piotr; Lachowicz, Dominika; Wultańska, Dorota; Karpiński, Paweł; Młynarczyk, Grażyna; van Dorp, Sofie M; Kuijper, Ed J

2015-01-01

As part of the European Clostridium difficile infections (CDI) surveillance Network (ECDIS-Net), which aims to build capacity for CDI surveillance in Europe, we constructed a new network of hospital-based laboratories in Poland. We performed a survey in 13 randomly selected hospital-laboratories in different sites of the country to determine their annual CDI incidence rates from 2011 to 2013. Information on C. difficile laboratory diagnostic testing and indications for testing was also collected. Moreover, for 2012 and 2013 respectively, participating hospital-laboratories sent all consecutive isolates from CDI patients between February and March to the Anaerobe Laboratory in Warsaw for further molecular characterisation, including the detection of toxin-encoding genes and polymerase chain reaction (PCR)-ribotyping. Within the network, the mean annual hospital CDI incidence rates were 6.1, 8.6 and 9.6 CDI per 10,000 patient-days in 2011, 2012, and 2013 respectively. Six of the 13 laboratories tested specimens only on the request of a physician, five tested samples of antibiotic-associated diarrhoea or samples from patients who developed diarrhoea more than two days after admission (nosocomial diarrhoea), while two tested all submitted diarrhoeal faecal samples. Most laboratories (9/13) used tests to detect glutamate dehydrogenase and toxin A/B either separately or in combination. In the two periods of molecular surveillance, a total of 166 strains were characterised. Of these, 159 were toxigenic and the majority belonged to two PCR-ribotypes: 027 (n=99; 62%) and the closely related ribotype 176 (n=22; 14%). The annual frequency of PCR-ribotype 027 was not significantly different during the surveillance periods (62.9% in 2012; 61.8% in 2013). Our results indicate that CDIs caused by PCR-ribotype 027 predominate in Polish hospitals participating in the surveillance, with the closely related 176 ribotype being the second most common agent of infection.

Low‐pathogenic notifiable avian influenza serosurveillance and the risk of infection in poultry – a critical review of the European Union active surveillance programme (2005–2007)

PubMed Central

Gonzales, J. L.; Elbers, A. R. W.; Bouma, A.; Koch, G.; De Wit, J. J.; Stegeman, J. A.

2010-01-01

Please cite this paper as: Gonzales et al. (2010) Low‐pathogenic notifiable avian influenza serosurveillance and the risk of infection in poultry – a critical review of the European Union active surveillance programme (2005–2007). Influenza and Other Respiratory Viruses 4(2), 91–99. Background  Since 2003, Member States (MS) of the European Union (EU) have implemented serosurveillance programmes for low pathogenic notifiable avian influenza (LPNAI) in poultry. To date, there is the need to evaluate the surveillance activity in order to optimize the programme’s surveillance design. Objectives  To evaluate MS sampling operations [sample size and targeted poultry types (PTs)] and its relation with the probability of detection and to estimate the PTs relative risk (RR) of being infected. Methods  Reported data of the surveillance carried out from 2005 to 2007 were analyzed using: (i) descriptive indicators to characterize both MS sampling operations and its relation with the probability of detection and the LPNAI epidemiological situation, and (ii) multivariable methods to estimate each PTs RR of being infected. Results  Member States sampling a higher sample size than that recommended by the EU had a significantly higher probability of detection. Poultry types with ducks & geese, game‐birds, ratites and “others” had a significant higher RR of being seropositive than chicken categories. The seroprevalence in duck & geese and game‐bird holdings appears to be higher than 5%, which is the EU‐recommended design prevalence (DP), while in chicken and turkey categories the seroprevalence was considerably lower than 5% and with that there is the risk of missing LPNAI seropositive holdings. Conclusion  It is recommended that the European Commission discusses with its MS whether the results of our evaluation calls for refinement of the surveillance characteristics such as sampling frequency, the between‐holding DP and MS sampling operation

Improving surveillance of sexually transmitted infections using mandatory electronic clinical reporting: the genitourinary medicine clinic activity dataset, England, 2009 to 2013.

PubMed

Savage, E J; Mohammed, H; Leong, G; Duffell, S; Hughes, G

2014-12-04

A new electronic surveillance system for sexually transmitted infections (STIs) was introduced in England in 2009. The genitourinary medicine clinic activity dataset (GUMCAD) is a mandatory, disaggregated, pseudo-anonymised data return submitted by all STI clinics across England. The dataset includes information on all STI diagnoses made and services provided alongside demographic characteristics for every patient attendance at a clinic. The new system enables the timely analysis and publication of routine STI data, detailed analyses of risk groups and longitudinal analyses of clinic attendees. The system offers flexibility so new codes can be introduced to help monitor outbreaks or unusual STI activity. From January 2009 to December 2013 inclusive, over twenty-five million records from a total of 6,668,648 patients of STI clinics have been submitted. This article describes the successful implementation of this new surveillance system and the types of epidemiological outputs and analyses that GUMCAD enables. The challenges faced are discussed and forthcoming developments in STI surveillance in England are described.

[Hospital infection in the maternity department. 3 years of surveillance in 9,204 deliveries of which 1,333 were cesarean sections].

PubMed

Tissot-Guerraz, F; Moussy, L; Agniel, F; André, A; Reverdy, M E; Miellet, C C; Audra, P; Putet, G; Sepetjan, M; Dargent, D

1990-01-01

Hospital or nosocomial infection, or infection acquired in hospitals, is a health problem in all hospital departments and particularly in the maternity department. We report on a prospective survey of surveillance of hospital-acquired infections both from the mother and the baby's point of view after delivery vaginally or with caesarean carried out at the obstetrical clinic of the Edouard Herriot Hospital in Lyon (France) over three successive years with a series of 9,204 deliveries. The incidence of infection in women who were delivered without caesarean section was 1.37% when urinary tract infections had been excluded but 13% in women who had caesarean sections. Endometritis, skin infections and urinary tract infections were the leading causes. As far as the newborn were concerned, hospital infection ran at about 2.60% and this in the main was due to staphylococcal pustules in the skin. These figures are still too high and prevention should be based on more information given and more care taken by the whole staff of such a hospital.

Polio eradication in India: progress, but environmental surveillance and vigilance still needed.

PubMed

Chatterjee, Animesh; Vidyant, Sanjukta; Dhole, Tapan N

2013-02-18

Poliomyelitis has appeared in epidemic form, become endemic on a global scale, and has been reduced to near elimination, all within the span of documented medical history. Nevertheless, effective vaccinations, global surveillance network, development of accurate viral diagnosis prompted the historical challenge, global polio eradication initiative (GPEI). Environmental surveillance of poliovirus means monitoring of wild polio virus (WPV) and vaccine derived polio virus (cVDPV) circulation in human populations by examining environmental specimens supposedly contaminated by human feces. The rationale for surveillance is based on the fact that PV-infected individuals, whether presenting with disease symptoms or not, shed large amounts of PV in the feces for several weeks. As the morbidity: infection ratio of PV infection is very low, and therefore this fact contributes to the sensitivity of poliovirus surveillance, which under optimal conditions can be better than that of the standard acute flaccid paralysis (AFP) surveillance. The World Health Organization (WHO) has included environmental surveillance of poliovirus in the new Strategic Plan of the Global Polio Eradication Initiative for years 2010-2012 to be increasingly used in PV surveillance, supplementing AFP surveillance and the strategic advisory group of experts on immunization (SAGE) recommended a switch from tOPV-bOPV to remove the threat of cVDPV2 and to accelerate the elimination of WPV type 1 and 3 as bOPV is a more immunogenic vaccine and to introduce one dose of IPV in their vaccination schedule prior to OPV cessation. Copyright © 2012 Elsevier Ltd. All rights reserved.

Population-based surveillance for scedosporiosis in Australia: epidemiology, disease manifestations and emergence of Scedosporium aurantiacum infection.

PubMed

Heath, C H; Slavin, M A; Sorrell, T C; Handke, R; Harun, A; Phillips, M; Nguyen, Q; Delhaes, L; Ellis, D; Meyer, W; Chen, S C A

2009-07-01

Australia-wide population-based surveillance for scedosporiosis identified 180 cases, with 118 (65.6%) cases of colonization and 62 (34.4%) cases of infection. Predisposing factors for isolation of Scedosporium spp. included chronic lung disease in 37.8% and malignancy in 21.7% of cases. Predictors of invasive disease (n=62) included haematological stem cell transplantation (n=7), leukaemia (n=16) and diabetes mellitus (n=8). Of 183 phenotypically-speciated isolates, 75 (41%) were Scedosporium prolificans (risk factors: haematologic cancer (n=17), neutropaenia (n=14)) and 108 (59%) had Scedosporium apiospermum/Pseudallescheria boydii phenotype [risk factor: diabetes (n=15)]. Scedosporium prolificans (p 0.01) and leukaemia (p 0.03) independently predicted death. Epidemiological and antifungal susceptibility profiles of Scedosporium aurantiacum (prevalence>or=15.8%) and S. apiospermum were similar. No patient with S. aurantiacum infection (n=6) died. This is the first description of clinical features associated with S. aurantiacum.

Surveillance for Chikungunya and Dengue During the First Year of Chikungunya Virus Circulation in Puerto Rico.

PubMed

Sharp, Tyler M; Ryff, Kyle R; Alvarado, Luisa; Shieh, Wun-Ju; Zaki, Sherif R; Margolis, Harold S; Rivera-Garcia, Brenda

2016-12-15

After chikungunya virus (CHIKV) transmission was detected in Puerto Rico in May 2014, multiple surveillance systems were used to describe epidemiologic trends and CHIKV-associated disease. Of 28 327 cases reported via passive surveillance, 6472 were tested for evidence of CHIKV infection, and results for 4399 (68%) were positive. Of 250 participants in household cluster investigations, 70 (28%) had evidence of recent CHIKV infection. Enhanced surveillance for chikungunya at 2 hospitals identified 1566 patients who tested positive for CHIKV, of whom 10.9% were hospitalized. Enhanced surveillance for fatal cases enabled identification of 31 cases in which CHIKV was detected in blood or tissue specimens. All surveillance systems detected a peak incidence of chikungunya in September 2014 and continued circulation in 2015. Concomitant surveillance for dengue demonstrated low incidence, which had decreased before CHIKV was introduced. Multifaceted chikungunya surveillance in Puerto Rico resolved gaps in traditional passive surveillance and enabled a holistic description of the spectrum of disease associated with CHIKV infection. Published by Oxford University Press for the Infectious Diseases Society of America 2016. This work is written by (a) US Government employee(s) and is in the public domain in the US.

Ambulatory Pediatric Surveillance of Hand, Foot and Mouth Disease as Signal of an Outbreak of Coxsackievirus A6 Infections, France, 2014–2015

PubMed Central

le Sage, François Vié; Pereira, Bruno; Cohen, Robert; Levy, Corinne; Archimbaud, Christine; Peigue-Lafeuille, Hélène; Bailly, Jean-Luc; Henquell, Cécile

2016-01-01

The clinical impact of enteroviruses associated with hand, foot and mouth disease (HFMD) is unknown outside Asia, and the prevalence of enterovirus A71 (EV-A71) in particular might be underestimated. To investigate the prevalence of enterovirus serotypes and the clinical presentations associated with HFMD in France, we conducted prospective ambulatory clinic–based surveillance of children during April 2014–March 2015. Throat or buccal swabs were collected from children with HFMD and tested for the enterovirus genome. Physical examinations were recorded on a standardized form. An enterovirus infection was detected in 523 (79.3%) of 659 children tested. Two epidemic waves occurred, dominated by coxsackievirus (CV) A6, which was detected in 53.9% of enterovirus-infected children. CV-A6 was more frequently related to atypical HFMD manifestations (eruptions extended to limbs and face). Early awareness and documentation of HFMD outbreaks can be achieved by syndromic surveillance of HFMD by ambulatory pediatricians and rapid enterovirus testing and genotyping. PMID:27767012

Rates of catheter-associated urinary tract infection in tertiary care hospitals in 3 Arabian Gulf countries: A 6-year surveillance study.

PubMed

Al Nasser, Wafa; El-Saed, Aiman; Al-Jardani, Amina; Althaqafi, Abdulhakeem; Alansari, Huda; Alsalman, Jameela; Maskari, Zaina Al; El Gammal, Ayman; Al-Abri, Seif S; Balkhy, Hanan H

2016-12-01

The true burden of catheter-associated urinary tract infections (CAUTIs) remains largely unknown because of a lack of national and regional surveillance reports in Gulf Cooperation Council (GCC) countries. The purpose of this study was to estimate location-specific CAUTI rates in the GCC region and to compare them with published reports from the U.S. National Healthcare Safety Network (NHSN) and the International Nosocomial Infection Control Consortium (INICC). CAUTI rates and urinary catheter utilization between 2008 and 2013 were calculated using NHSN methodology pooled from 6 hospitals in 3 GCC countries: Saudi Arabia, Oman, and Bahrain. The standardized infection ratios of the CAUTIs were compared with published reports of the NHSN and INICC. A total of 286 CAUTI events were diagnosed during 6 years of surveillance, covering 89,254 catheter days and 113,807 patient days. The overall CAUTI rate was 3.2 per 1,000 catheter days (95% confidence interval, 2.8-3.6), with an overall urinary catheter utilization of 0.78. The CAUTI rates showed a wide variability between participating hospitals, with approximately 80% reduction during the study. The overall compliance with the urinary catheter bundle implementation during the second half of the study was 65%. The risk of CAUTI in GCC hospitals was 35% higher than the NHSN hospitals, but 37% lower than the INICC hospitals. CAUTI rates pooled from a sample of GCC hospitals are quite different from rates in both developing and developed countries. Copyright © 2016 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Objective Sepsis Surveillance Using Electronic Clinical Data

PubMed Central

Rhee, Chanu; Kadri, Sameer; Huang, Susan S.; Murphy, Michael V.; Li, Lingling; Platt, Richard; Klompas, Michael

2016-01-01

OBJECTIVE To compare the accuracy of surveillance of severe sepsis using electronic health record clinical data vs claims and to compare incidence and mortality trends using both methods. DESIGN We created an electronic health record–based surveillance definition for severe sepsis using clinical indicators of infection (blood culture and antibiotic orders) and concurrent organ dysfunction (vasopressors, mechanical ventilation, and/or abnormal laboratory values). We reviewed 1,000 randomly selected medical charts to characterize the definition’s accuracy and stability over time compared with a claims-based definition requiring infection and organ dysfunction codes. We compared incidence and mortality trends from 2003–2012 using both methods. SETTING Two US academic hospitals. PATIENTS Adult inpatients. RESULTS The electronic health record–based clinical surveillance definition had stable and high sensitivity over time (77% in 2003–2009 vs 80% in 2012, P=.58) whereas the sensitivity of claims increased (52% in 2003–2009 vs 67% in 2012, P=.02). Positive predictive values for claims and clinical surveillance definitions were comparable (55% vs 53%, P=.65) and stable over time. From 2003 to 2012, severe sepsis incidence imputed from claims rose by 72% (95% CI, 57%–88%) and absolute mortality declined by 5.4% (95% CI, 4.6%–6.7%). In contrast, incidence using the clinical surveillance definition increased by 7.7% (95% CI, −1.1% to 17%) and mortality declined by 1.7% (95% CI, 1.1%–2.3%). CONCLUSIONS Sepsis surveillance using clinical data is more sensitive and more stable over time compared with claims and can be done electronically. This may enable more reliable estimates of sepsis burden and trends. PMID:26526737

The problems of professional training of practice-oriented specialists for small enterprises of footwear and leather production industries in Uzbekistan

NASA Astrophysics Data System (ADS)

Ilkhamova, M. U.; Gafurov, J. K.; Maksudova, U. M.; Vassiliadis, S.

2017-10-01

At the present, the State authorities of the Republic of Uzbekistan pay special attention to the development of small and medium businesses and, in particular, to the enterprises oriented on manufacturing products with high added value. The leather and footwear industry of Uzbekistan is one of the dynamically developing sectors of economy. However, the study of the situation demonstrates that the increase in number of small and medium footwear and leather enterprises that have taken place in recent years, is not accompanied by a formation of corresponding professional training system for the enterprises, especially for associate specialists. The analysis of the legal base disclosed that the professional training level in footwear industry enterprises does not meet the up-to-date manufacturing requirements. The study is devoted to the issues of professional training of practice-oriented staff - the specialists for small enterprises of footwear and leather industry. The main task is the development of new vocational courses and programs for the training and professional development of personnel at all levels. The basic stages of complete staff training cycle for footwear sector have been determined based on the practical experience of staff training for small footwear enterprises in Greece. The 3-6 months duration short-term courses recommended for associate and medium level specialists have been developed and evaluated.

Development and validation of an automated ventilator-associated event electronic surveillance system: A report of a successful implementation.

PubMed

Hebert, Courtney; Flaherty, Jennifer; Smyer, Justin; Ding, Jing; Mangino, Julie E

2018-03-01

Surveillance is an important tool for infection control; however, this task can often be time-consuming and take away from infection prevention activities. With the increasing availability of comprehensive electronic health records, there is an opportunity to automate these surveillance activities. The objective of this article is to describe the implementation of an electronic algorithm for ventilator-associated events (VAEs) at a large academic medical center METHODS: This article reports on a 6-month manual validation of a dashboard for VAEs. We developed a computerized algorithm for automatically detecting VAEs and compared the output of this algorithm to the traditional, manual method of VAE surveillance. Manual surveillance by the infection preventionists identified 13 possible and 11 probable ventilator-associated pneumonias (VAPs), and the VAE dashboard identified 16 possible and 13 probable VAPs. The dashboard had 100% sensitivity and 100% accuracy when compared with manual surveillance for possible and probable VAP. We report on the successfully implemented VAE dashboard. Workflow of the infection preventionists was simplified after implementation of the dashboard with subjective time-savings reported. Implementing a computerized dashboard for VAE surveillance at a medical center with a comprehensive electronic health record is feasible; however, this required significant initial and ongoing work on the part of data analysts and infection preventionists. Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Infectious disease surveillance during emergency relief to Bhutanese refugees in Nepal.

PubMed

Marfin, A A; Moore, J; Collins, C; Biellik, R; Kattel, U; Toole, M J; Moore, P S

1994-08-03

To implement simplified infectious disease surveillance and epidemic disease control during the relocation of Bhutanese refugees to Nepal. Longitudinal observation study of mortality and morbidity. Refugee health units in six refugee camps housing 73,500 Bhutanese refugees in the eastern tropical lowland between Nepal and India. Infectious disease surveillance and community-based programs to promote vitamin A supplementation, measles vaccination, oral rehydration therapy, and early use of antibiotics to treat acute respiratory infection. Crude mortality rate, mortality rate for children younger than 5 years, and cause-specific mortality. Crude mortality rates up to 1.15 deaths per 10,000 persons per day were reported during the first 6 months of surveillance. The leading causes of death were measles, diarrhea, and acute respiratory infections. Surveillance data were used to institute changes in public health management including measles vaccination, vitamin A supplementation, and control programs for diarrhea and acute respiratory infections and to ensure rapid responses to cholera, Shigella dysentery, and meningoencephalitis. Within 4 months of establishing disease control interventions, crude mortality rates were reduced by 75% and were below emergency levels. Simple, sustainable disease surveillance in refugee populations is essential during emergency relief efforts. Data can be used to direct community-based public health interventions to control common infectious diseases and reduce high mortality rates among refugees while placing a minimal burden on health workers.

Trends in HIV infection surveillance data among men who have sex with men in Norway, 1995-2011

PubMed Central

2013-01-01

Background Recent reports on the growing HIV epidemic among men who have sex with men (MSM) in the EU/EEA area were accompanied by an increase of reported HIV among MSM in Oslo, Norway in 2003. Our study with data from 1995 to 2011 has described the recent trends of HIV among MSM in Norway and their socio-demographic and epidemiological characteristics. Methods The data were collected from the Norwegian Surveillance System for Communicable Diseases. Cases were described by age, place of infection, clinical presentation of HIV infection, STI co-infection and source partner. We used simple linear regression to estimate trends over time. Results During the study period, 991 MSM, aged from 16 to 80 years, were newly diagnosed with HIV. No significant trends over time in overall median age (36 years) were observed. Most of the MSM (505, 51%) were infected in Oslo. In the years 1995-2002, 30 to 45 MSM were diagnosed with HIV each year, while in the years 2003-2011 this increased to between 56 and 97 cases. The proportion of MSM, presenting with either AIDS or HIV illness, decreased over time, while asymptomatic and acute HIV illness increased (p for trend=0.034 or less). STI co-infection was reported in 133 (13%) cases. An overall increase of syphilis co-infected cases was observed (p for trend <0.001). A casual partner was a source of infection in 590 cases (60%). Conclusions Though the increases described could be attributed to earlier testing and diagnosis, no change in the median age of cases was observed. This indicates that it is likely that there has been an increase in HIV infections among MSM in Norway since 2003. The simultaneous increase in STI co-infections indicates risky sexual behaviour and a potential to spread both HIV and other sexually transmitted infections. PMID:23414557

Case based rubella surveillance in Abia State, South East Nigeria, 2007-2011.

PubMed

Umeh, Chukwuemeka Anthony; Onyi, Stella Chioma

2014-01-01

Introduction. Rubella infection has the potential of causing severe fetal birth defects collectively called congenital rubella syndrome (CRS) if the mother is infected early in pregnancy. However, little is known about rubella and CRS epidemiology in Nigeria and rubella vaccines are still not part of routine childhood immunization in Nigeria. Methods. Analysis of confirmed cases of rubella in Abia State, Nigeria from 2007 to 2011 detected through Abia State Integrated Disease Surveillance and Response system. Results. Of the 757 febrile rash cases, 81(10.7%) tested positive for rubella immunoglobulin M (IgM). New rubella infection decreased from 6.81/1,000,000 population in 2007 to 2.28/1,000,000 in 2009 and increased to 6.34/1,000,000 in 2011. The relative risk of rubella was 1.5 (CI [0.98-2.28]) times as high in females compared to males and 1.6 times (CI [0.90-2.91]) as high in rural areas compared to urban areas. Eighty six percent of rubella infections occurred in children less than 15 years with a high proportion of cases occurring between 5 and 14 years. Conclusion. Rubella infection in Abia State, Nigeria is predominantly in those who are younger than 15 years old. It is also more prevalent in females and in those living in rural areas of the state. Unfortunately, there is no surveillance of CRS in Nigeria and so the public health impact of rubella infection in the state is not known. Efforts should be made to expand the rubella surveillance in Nigeria to incorporate surveillance for CRS.

Surveillance of avian influenza in the Caribbean through the Caribbean Animal Health Network: surveillance tools and epidemiologic studies.

PubMed

Lefrançois, T; Hendrikx, P; Ehrhardt, N; Millien, M; Gomez, L; Gouyet, L; Gaidet, N; Gerbier, G; Vachiéry, N; Petitclerc, F; Carasco-Lacombe, C; Pinarello, V; Ahoussou, S; Levesque, A; Gongora, H V; Trotman, M

2010-03-01

The Caribbean region is considered to be at risk for avian influenza (AI) due to a large backyard poultry system, an important commercial poultry production system, the presence of migratory birds, and disparities in the surveillance systems. The Caribbean Animal Health Network (CaribVET) has developed tools to implement AI surveillance in the region with the goals to have 1) a regionally harmonized surveillance protocol and specific web pages for AI surveillance on www.caribvet.net, and 2) an active and passive surveillance for AI in domestic and wild birds. A diagnostic network for the Caribbean, including technology transfer and AI virus molecular diagnostic capability in Guadeloupe (real-time reverse transcription-polymerase chain reaction for the AI virus matrix gene), was developed. Between 2006 and 2009, 627 samples from four Caribbean countries were tested for three circumstances: importation purposes, following a clinical suspicion of AI, or through an active survey of wild birds (mainly waders) during the southward and northward migration periods in Guadeloupe. None of the samples tested were positive, suggesting a limited role of these species in the AI virus ecology in the Caribbean. Following low pathogenic H5N2 outbreaks in the Dominican Republic in 2007, a questionnaire was developed to collect data for a risk analysis of AI spread in the region through fighting cocks. The infection pathway of the Martinique commercial poultry sector by AI, through introduction of infected cocks, was designed, and recommendations were provided to the Caribbean Veterinary Services to improve cock movement control and biosecurity measures. The CaribVET and its organization allowed interaction between diagnostic and surveillance tools on the one hand and epidemiologic studies on the other, both of them developed in congruence with regional strategies. Together, these CaribVET activities contribute to strengthening surveillance of avian influenza virus (AIV) in the

Bootstrap confidence intervals and bias correction in the estimation of HIV incidence from surveillance data with testing for recent infection.

PubMed

Carnegie, Nicole Bohme

2011-04-15

The incidence of new infections is a key measure of the status of the HIV epidemic, but accurate measurement of incidence is often constrained by limited data. Karon et al. (Statist. Med. 2008; 27:4617–4633) developed a model to estimate the incidence of HIV infection from surveillance data with biologic testing for recent infection for newly diagnosed cases. This method has been implemented by public health departments across the United States and is behind the new national incidence estimates, which are about 40 per cent higher than previous estimates. We show that the delta method approximation given for the variance of the estimator is incomplete, leading to an inflated variance estimate. This contributes to the generation of overly conservative confidence intervals, potentially obscuring important differences between populations. We demonstrate via simulation that an innovative model-based bootstrap method using the specified model for the infection and surveillance process improves confidence interval coverage and adjusts for the bias in the point estimate. Confidence interval coverage is about 94–97 per cent after correction, compared with 96–99 per cent before. The simulated bias in the estimate of incidence ranges from −6.3 to +14.6 per cent under the original model but is consistently under 1 per cent after correction by the model-based bootstrap. In an application to data from King County, Washington in 2007 we observe correction of 7.2 per cent relative bias in the incidence estimate and a 66 per cent reduction in the width of the 95 per cent confidence interval using this method. We provide open-source software to implement the method that can also be extended for alternate models.

Avian influenza surveillance in wild birds in the European Union in 2006.

PubMed

Hesterberg, Uta; Harris, Kate; Stroud, David; Guberti, Vittorio; Busani, Luca; Pittman, Maria; Piazza, Valentina; Cook, Alasdair; Brown, Ian

2009-01-01

Infections of wild birds with highly pathogenic avian influenza (AI) subtype H5N1 virus were reported for the first time in the European Union in 2006. To capture epidemiological information on H5N1 HPAI in wild bird populations through large-scale surveillance and extensive data collection. Records were analysed at bird level to explore the epidemiology of AI with regard to species of wild birds involved, timing and location of infections as well as the applicability of different surveillance types for the detection of infections. In total, 120,706 records of birds were sent to the Community Reference Laboratory for analysis. Incidents of H5N1 HPAI in wild birds were detected in 14 EU Member States during 2006. All of these incidents occurred between February and May, with the exception of two single cases during the summer months in Germany and Spain. For the detection of H5N1 HPAI virus, passive surveillance of dead or diseased birds appeared the most effective approach, whilst active surveillance offered better detection of low pathogenic avian influenza (LPAI) viruses. No carrier species for H5N1 HPAI virus could be identified and almost all birds infected with H5N1 HPAI virus were either dead or showed clinical signs. A very large number of Mallards (Anas platyrhynchos) were tested in 2006 and while a high proportion of LPAI infections were found in this species, H5N1 HPAI virus was rarely identified in these birds. Orders of species that appeared to be very clinically susceptible to H5N1 HPAI virus were swans, diving ducks, mergansers and grebes, supporting experimental evidence. Surveillance results indicate that H5N1 HPAI virus did not establish itself successfully in the EU wild bird population in 2006.

Methods for molecular surveillance of influenza.

PubMed

Wang, Ruixue; Taubenberger, Jeffery K

2010-05-01

Molecular-based techniques for detecting influenza viruses have become an integral component of human and animal surveillance programs in the last two decades. The recent pandemic of the swine-origin influenza A virus (H1N1) and the continuing circulation of highly pathogenic avian influenza A virus (H5N1) further stress the need for rapid and accurate identification and subtyping of influenza viruses for surveillance, outbreak management, diagnosis and treatment. There has been remarkable progress on the detection and molecular characterization of influenza virus infections in clinical, mammalian, domestic poultry and wild bird samples in recent years. The application of these techniques, including reverse transcriptase-PCR, real-time PCR, microarrays and other nucleic acid sequencing-based amplifications, have greatly enhanced the capability for surveillance and characterization of influenza viruses.

Surveillance and compartmentalisation as a tool to control avian influenza.

PubMed

Zepeda, C

2006-01-01

Surveillance for avian influenza can have several objectives. Generally, these are to detect the presence of infection or to declare disease freedom. Claims for disease freedom can refer to an entire country, a zone within a country, or a compartment. Disease freedom cannot be demonstrated absolutely; however, through a multi-pronged approach employing different surveillance strategies, sufficient confidence in the absence of infection can be achieved. The recently developed OIE guidelines for surveillance for avian influenza offer different approaches to meet these goals. The guidelines are not intended to be prescriptive but rather offer options that countries may apply depending on their epidemiological situation. Compartmentalisation is a new concept that allows the recognition of populations of different health status based on management as opposed to geographic factors (regionalisation). A proposed approach for the application of this novel concept is presented.

Consensus on the clinical management, screening-to-treat, and surveillance of Helicobacter pylori infection to improve gastric cancer control on a nationwide scale.

PubMed

Sheu, Bor-Shyang; Wu, Ming-Shiang; Chiu, Cheng-Tang; Lo, Jing-Chuan; Wu, Deng-Chyang; Liou, Jyh-Ming; Wu, Chun-Ying; Cheng, Hsiu-Chi; Lee, Yi-Chia; Hsu, Ping-I; Chang, Chun-Chao; Chang, Wei-Lun; Lin, Jaw-Town

2017-06-01

Previous international consensus statements provided general policies for the management of Helicobacter pylori infection. However, there are geographic differences in the prevalence and antimicrobial resistance of H. pylori, and in the availability of medications and endoscopy. Thus, nationwide or regional consensus statements are needed to improve control of H. pylori infection and gastric cancer. This consensus statement for management of H. pylori in Taiwan has three major sections: (1) optimal diagnosis and indications; (2) current treatment strategies; and (3) screening-to-treat and surveillance for control of gastric cancer. The literature review emphasized recent data for development of draft statements and determination of levels of evidence. Twenty-five Taiwan experts conducted a consensus conference, by a modified Delphi process, to modify the draft statements. Consensus, defined as an agreement of least 80% of the experts, and recommendation grade were determined by anonymous voting. There were 24 consensus statements. Section 1 has seven statements on recommendations for the diagnosis and indications for treatment of H. pylori infection. Section 2 has 10 statements that provide an updated treatment algorithm for first-line, second-line, and third-line regimens. Section 3 has seven statements regarding H. pylori eradication for reducing the risk of gastric cancer, with a cost-benefit analysis. After H. pylori eradication, the consensus highlights the use of endoscopic surveillance and/or chemoprevention to further reduce the burden of gastric cancer. This consensus statement has updated recommendations for improving the clinical management of H. pylori infection in areas such as Taiwan, which have high prevalence of H. pylori infection and gastric cancer. © 2017 The Authors. Helicobacter Published by John Wiley & Sons Ltd.

Twins prematurity--the influence of prenatal surveillance.

PubMed

Domingues, Ana Patrícia; Fonseca, Etelvina; Belo, Adriana; Moura, Paulo

2015-06-01

To evaluate the influence of the local prenatal surveillance of twin pregnancies in the obstetrical results. A prospective cohort study of multiple pregnancies delivered over a period of 16 years in a tertiary centre was conducted. In this study 861 twin pregnancies were included. They were compared for obstetric complications, gestational age at delivery, mode of delivery and birthweight, according to the place of the surveillance. Of the 861 cases examined, the following obstetric complications were significantly different: metrorrhagia (p = 0.039), infections (p < 0.001), HELLP (p = 0.007), PROMPT (p < 0.001) and fetal death (p = 0.024). The mode of delivery was similar but occurred mostly ≤32 weeks (p < 0.001), the birthweight was mostly <2000 g and occurred more NICU admission (p < 0.001) when surveillance was outside the MPC-MDM. Our results demonstrate the crucial importance of prenatal surveillance be carried in a differentiated referral centers with specific/strict protocols or the urgent implementation of same protocols in all other places of surveillance, since this straight surveillance greatly reduces the occurrence of prenatal complications, mainly PROMPT, PTD.

[Microbiological surveillance in patients treated by bone marrow transplantation (author's transl)].

PubMed

Haralambie, E; Linzenmeier, G; Nowrousian, M; Schäfer, R; Schmidt, C G

1980-01-01

Patients suffering from acute leukemia were treated by bone marrow transplantation under strict gnotobiotic conditions. The microbiological surveillance was performed during three phases: the admission phase, the phase of decontamination and reverse isolation and the reconventionalisation phase. During the second phase no infections of exogenous origine occurred. All clinically manifest infections in this phase were induced by unsuppressed endogenous bacteria. In our study the bacteria of oropharynx was the main source of infections therefore this biotop deserves special attention during the microbiological surveillance of the immune compromised host. In leukemia patients selective decontamination will be the method of choice, but considering the possibility of GvHR in patients with bone marrow transplantation a complete decontamination should be achieved.

Surveillance cultures in intensive care units: a nationwide survey on current practice providing future perspectives.

PubMed

Scholte, Johannes B J; van Mook, Walther N K A; Linssen, Catharina F M; van Dessel, Helke A; Bergmans, Dennis C J J; Savelkoul, Paul H M; Roekaerts, Paul M H J

2014-10-01

To explore the extent of surveillance culture (SC) implementation underlying motives for obtaining SC and decision making based on the results. A questionnaire was distributed to Heads of Department (HODs) and microbiologists within all intensive care departments in the Netherlands. Response was provided by 75 (79%) of 95 HODs and 38 (64%) of 59 laboratories allied to an intensive care unit (ICU). Surveillance cultures were routinely obtained according to 55 (73%) of 75 HODs and 33 (87%) of 38 microbiologists. Surveillance cultures were obtained in more than 80% of higher-level ICUs and in 58% of lower-level ICUs (P < .05). Surveillance cultures were obtained twice weekly (88%) and sampled from trachea (87%), pharynx (74%), and rectum (68%). Thirty (58%) of 52 HODs obtained SC to optimize individual patient treatment. On suspicion of infection from an unknown source, microorganisms identified by SC were targeted according to 87%. One third of HODs targeted microorganisms identified by SC in the case of an infection not at the location where the SC was obtained. This was significantly more often than microbiologists in case of no infection (P = .02) or infection of unknown origin (P < .05). Surveillance culture implementation is common in Dutch ICUs to optimize individual patients' treatment. Consensus is lacking on how to deal with SC results when the focus of infection is not at the sampled site. Copyright © 2014 Elsevier Inc. All rights reserved.

Notice to Readers: The Effect of Falsified Clostridium difficile Infections Surveillance Data on Results Reported in MMWR.

PubMed

2015-09-11

In 2012, MMWR published the report, "Vital Signs: Preventing Clostridium difficile Infections," which examined Clostridium difficile infection (CDI) surveillance data. This report contained several errors pertaining to Emerging Infections Program (EIP) data. These errors occurred as a result of scientific misconduct by a former employee of the Oregon Health Authority. The Public Health Service Office of Research Integrity has determined that the former employee falsified or fabricated data for 56 Oregon EIP CDI case report forms (https://ori.hhs.gov/content/case-summary-asherin-ryan). The authors re-analyzed the EIP data to determine if the removal of all Oregon CDI cases (57 total cases) from the 10,342 cases included in the original publication altered the previously reported results. It did not. Re-analysis confirms the conclusions in the original report. Data in the original report from sources other than the Oregon Health Authority (i.e., from other EIP sites, the National Healthcare Safety Network, and Illinois, Massachusetts, and New York CDI prevention programs) were not involved in the research misconduct.Errata for the 2012 report have been published in this issue of MMWR.

The role of supplementary environmental surveillance to complement acute flaccid paralysis surveillance for wild poliovirus in Pakistan - 2011-2013.

PubMed

Cowger, Tori L; Burns, Cara C; Sharif, Salmaan; Gary, Howard E; Iber, Jane; Henderson, Elizabeth; Malik, Farzana; Zahoor Zaidi, Syed Sohail; Shaukat, Shahzad; Rehman, Lubna; Pallansch, Mark A; Orenstein, Walter A

2017-01-01

More than 99% of poliovirus infections are non-paralytic and therefore, not detected by acute flaccid paralysis (AFP) surveillance. Environmental surveillance (ES) can detect circulating polioviruses from sewage without relying on clinical presentation. With extensive ES and continued circulation of polioviruses, Pakistan presents a unique opportunity to quantify the impact of ES as a supplement to AFP surveillance on overall completeness and timeliness of poliovirus detection. Genetic, geographic and temporal data were obtained for all wild poliovirus (WPV) isolates detected in Pakistan from January 2011 through December 2013. We used viral genetics to assess gaps in AFP surveillance and ES as measured by detection of 'orphan viruses' (≥1.5% different in VP1 capsid nucleotide sequence). We compared preceding detection of closely related circulating isolates (≥99% identity) detected by AFP surveillance or ES to determine which surveillance system first detected circulation before the presentation of each polio case. A total of 1,127 WPV isolates were detected by AFP surveillance and ES in Pakistan from 2011-2013. AFP surveillance and ES combined exhibited fewer gaps (i.e., % orphan viruses) in detection than AFP surveillance alone (3.3% vs. 7.7%, respectively). ES detected circulation before AFP surveillance in nearly 60% of polio cases (200 of 346). For polio cases reported from provinces conducting ES, ES detected circulation nearly four months sooner on average (117.6 days) than did AFP surveillance. Our findings suggest ES in Pakistan is providing earlier, more sensitive detection of wild polioviruses than AFP surveillance alone. Overall, targeted ES through strategic selection of sites has important implications in the eradication endgame strategy.

Neurological manifestations of influenza infection in children and adults: results of a National British Surveillance Study.

PubMed

Goenka, Anu; Michael, Benedict D; Ledger, Elizabeth; Hart, Ian J; Absoud, Michael; Chow, Gabriel; Lilleker, James; Lunn, Michael; McKee, David; Peake, Deirdre; Pysden, Karen; Roberts, Mark; Carrol, Enitan D; Lim, Ming; Avula, Shivaram; Solomon, Tom; Kneen, Rachel

2014-03-01

The emergence of influenza A(H1N1) 2009 was met with increased reports of associated neurological manifestations. We aimed to describe neurological manifestations of influenza in adults and children in the United Kingdom that presented at this time. A 2-year surveillance study was undertaken through the British adult and pediatric neurological surveillance units from February 2011. Patients were included if they met clinical case definitions within 1 month of proven influenza infection. Twenty-five cases were identified: 21 (84%) in children and 4 (16%) in adults. Six (29%) children had preexisting neurological disorders. Polymerase chain reaction of respiratory secretions identified influenza A in 21 (81%; 20 of which [95%] were H1N1) and influenza B in 4 (15%). Twelve children had encephalopathy (1 with movement disorder), 8 had encephalitis, and 1 had meningoencephalitis. Two adults had encephalopathy with movement disorder, 1 had encephalitis, and 1 had Guillain-Barré syndrome. Seven individuals (6 children) had specific acute encephalopathy syndromes (4 acute necrotizing encephalopathy, 1 acute infantile encephalopathy predominantly affecting the frontal lobes, 1 hemorrhagic shock and encephalopathy, 1 acute hemorrhagic leukoencephalopathy). Twenty (80%) required intensive care, 17 (68%) had poor outcome, and 4 (16%) died. This surveillance study described a cohort of adults and children with neurological manifestations of influenza. The majority were due to H1N1. More children than adults were identified; many children had specific encephalopathy syndromes with poor outcomes. None had been vaccinated, although 8 (32%) had indications for this. A modified classification system is proposed based on our data and the increasing spectrum of recognized acute encephalopathy syndromes.

Travel-acquired infections and illnesses in Canadians: surveillance report from CanTravNet surveillance data, 2009-2011.

PubMed

Boggild, Andrea K; Geduld, Jennifer; Libman, Michael; Ward, Brian J; McCarthy, Anne E; Doyle, Patrick W; Ghesquiere, Wayne; Vincelette, Jean; Kuhn, Susan; Freedman, David O; Kain, Kevin C

2014-01-01

Important knowledge gaps exist in our understanding of migration medicine practice and the impact of pathogens imported by Canadian travellers. We present here a comprehensive, Canada-specific surveillance summary of illness in a cohort of returned Canadian travellers and new immigrants. We extracted and analyzed (using standard parametric and nonparametric techniques) data from the Canadian Travel Medicine Network (CanTravNet) database for ill returned Canadian travellers and new immigrants who presented to a Canadian GeoSentinel Surveillance Network site between September 2009 and September 2011. During the study period, 4365 travellers and immigrants presented to a CanTravNet site, 3943 (90.3%) of whom were assigned a travel-related diagnosis. Among the 3115 non-immigrant travellers with a definitive travel-related diagnosis, arthropod bite (n = 127 [4.1%]), giardiasis (n = 91 [2.9%]), malaria (n = 77 [2.5%]), latent tuberculosis (n = 73 [2.3%]), and strongyloidiasis (n = 66 [2.1%]) were the most common specific etiologic diagnoses. Among the 828 immigrants with definitive travel-related diagnoses, the most frequent etiologies were latent tuberculosis (n = 229 [27.7%]), chronic hepatitis B (n = 182 [22.0%]), active tuberculosis (n = 97 [11.7%]), chronic hepatitis C (n = 89 [10.7%]), and strongyloidiasis (n = 41 [5.0%]). Potentially serious infections, such as dengue fever (61 cases) and enteric fever due to Salmonella enterica serotype Typhi or Paratyphi (36 cases), were common. Individuals travelling for the purpose of visiting friends and relatives (n = 500 [11.6% of those with known reason for travel]) were over-represented among those diagnosed with malaria and enteric fever, compared with other illnesses (for malaria 34/94 [36.2%] v. 466/4221 [11.0%]; for enteric fever, 17/36 [47.2%] v. 483/4279 [11.3%]) (both p < 0.001). For cases of malaria, there was also overrepresentation (compared with other illnesses) from business travellers (22/94 [23.4%] v. 337

Estimating HIV incidence and detection rates from surveillance data.

PubMed

Posner, Stephanie J; Myers, Leann; Hassig, Susan E; Rice, Janet C; Kissinger, Patricia; Farley, Thomas A

2004-03-01

Markov models that incorporate HIV test information can increase precision in estimates of new infections and permit the estimation of detection rates. The purpose of this study was to assess the functioning of a Markov model for estimating new HIV infections and HIV detection rates in Louisiana using surveillance data. We expanded a discrete-time Markov model by accounting for the change in AIDS case definition made by the Centers for Disease Control and Prevention in 1993. The model was applied to quarterly HIV/AIDS surveillance data reported in Louisiana from 1981 to 1996 for various exposure and demographic subgroups. When modeling subgroups defined by exposure categories, we adjusted for the high proportion of missing exposure information among recent cases. We ascertained sensitivity to changes in various model assumptions. The model was able to produce results consistent with other sources of information in the state. Estimates of new infections indicated a transition of the HIV epidemic in Louisiana from (1) predominantly white men and men who have sex with men to (2) women, blacks, and high-risk heterosexuals. The model estimated that 61% of all HIV/AIDS cases were detected and reported by 1996, yet half of all HIV/non-AIDS cases were yet to be detected. Sensitivity analyses demonstrated that the model was robust to several uncertainties. In general, the methodology provided a useful and flexible alternative for estimating infection and detection trends using data from a U.S. surveillance program. Its use for estimating current infection will need further exploration to address assumptions related to newer treatments.

Performance of statistical process control methods for regional surgical site infection surveillance: a 10-year multicentre pilot study.

PubMed

Baker, Arthur W; Haridy, Salah; Salem, Joseph; Ilieş, Iulian; Ergai, Awatef O; Samareh, Aven; Andrianas, Nicholas; Benneyan, James C; Sexton, Daniel J; Anderson, Deverick J

2017-11-24

Traditional strategies for surveillance of surgical site infections (SSI) have multiple limitations, including delayed and incomplete outbreak detection. Statistical process control (SPC) methods address these deficiencies by combining longitudinal analysis with graphical presentation of data. We performed a pilot study within a large network of community hospitals to evaluate performance of SPC methods for detecting SSI outbreaks. We applied conventional Shewhart and exponentially weighted moving average (EWMA) SPC charts to 10 previously investigated SSI outbreaks that occurred from 2003 to 2013. We compared the results of SPC surveillance to the results of traditional SSI surveillance methods. Then, we analysed the performance of modified SPC charts constructed with different outbreak detection rules, EWMA smoothing factors and baseline SSI rate calculations. Conventional Shewhart and EWMA SPC charts both detected 8 of the 10 SSI outbreaks analysed, in each case prior to the date of traditional detection. Among detected outbreaks, conventional Shewhart chart detection occurred a median of 12 months prior to outbreak onset and 22 months prior to traditional detection. Conventional EWMA chart detection occurred a median of 7 months prior to outbreak onset and 14 months prior to traditional detection. Modified Shewhart and EWMA charts additionally detected several outbreaks earlier than conventional SPC charts. Shewhart and SPC charts had low false-positive rates when used to analyse separate control hospital SSI data. Our findings illustrate the potential usefulness and feasibility of real-time SPC surveillance of SSI to rapidly identify outbreaks and improve patient safety. Further study is needed to optimise SPC chart selection and calculation, statistical outbreak detection rules and the process for reacting to signals of potential outbreaks. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights

A Simulation Model to Determine Sensitivity and Timeliness of Surveillance Strategies.

PubMed

Schulz, J; Staubach, C; Conraths, F J; Schulz, K

2017-12-01

Animal surveillance systems need regular evaluation. We developed an easily applicable simulation model of the German wild boar population to investigate two evaluation attributes: the sensitivity and timeliness (i.e. the ability to detect a disease outbreak rapidly) of a surveillance system. Classical swine fever (CSF) was used as an example for the model. CSF is an infectious disease that may lead to massive economic losses. It can affect wild boar as well as domestic pigs, and CSF outbreaks in domestic pigs have been linked to infections in wild boar. Awareness of the CSF status in wild boar is therefore vital. Our non-epidemic simulation model is based on real data and evaluates the currently implemented German surveillance system for CSF in wild boar. The results show that active surveillance for CSF fulfils the requirements of detecting an outbreak with 95% confidence within one year after the introduction of CSF into the wild boar population. Nevertheless, there is room for improved performance and efficiency by more homogeneous (active and passive) sampling of wild boar over the year. Passive surveillance alone is not sufficient to meet the requirements for detecting the infection. Although CSF was used as example to develop the model, it may also be applied to the evaluation of other surveillance systems for viral diseases in wild boar. It is also possible to compare sensitivity and timeliness across hypothetical alternative or risk-based surveillance strategies. © 2016 Blackwell Verlag GmbH.

Hepatocellular Carcinoma Surveillance Rates in Commercially Insured Patients with Non-Cirrhotic Chronic Hepatitis B

PubMed Central

Goldberg, David S.; Valderrama, Adriana; Kamalakar, Rajesh; Sansgiry, Sujit S; Babajanyan, Svetlana; Lewis, James D.

2015-01-01

AASLD and EASL guidelines recommend biannual hepatocellular carcinoma (HCC) screening for non-cirrhotic patients with chronic hepatitis B infection (HBV), yet there are no data estimating surveillance rates or factors associated with surveillance. We performed a retrospective cohort study of U.S. patients using the Truven Health Analytics databases from 2006-2010, and identified patients with non-cirrhotic chronic HBV. Surveillance patterns were characterized using categorical and continuous outcomes, with the continuous measure of the proportion of time “up-to-date” with surveillance (PUTDS), with the six-month interval following each ultrasound categorized as “up-to-date.” During a median follow-up of 26.0 (IQR: 16.2-40.0) months among 4,576 non-cirrhotic patients with chronic HBV (median age: 44 years, IQR: 36-52), only 306 (6.7%) had complete surveillance (one ultrasound every 6-month interval), 2,727 (59.6%) incomplete (≥1 ultrasound), and 1,543 (33.7%) none. The mean PUTDS was 0.34 ± 0.29, and the median was 0.32 (IQR: 0.03-0.52). In multinomial logistic regression models, patients diagnosed by a non-gastroenterologist were significantly less likely to have complete surveillance (p<0.001), as were those co-infected with HBV/HIV (p<0.001). In linear regression models, non-gastroenterologist provider, health insurance subtype, HBV/HIV co-infection, rural status, and metabolic syndrome were independently associated with decreased surveillance. Patients with HIV had an absolute decrease in the PUTDS of 0.24, while patients in less populated rural areas had an absolute decrease of 0.10. HCC surveillance rates in non-cirrhotic patients with chronic HBV in the United States are poor, and lower than reported rates of HCC surveillance in cirrhotic patients. PMID:25581816

[The current prevalence of Chlamydia trachomatis infection among teenagers and young asymptomatic Chilean women justifies the periodic surveillance].

PubMed

Zamboni, Milena; Ralph, Constanza; García, Patricia; Cuello, Mauricio

2016-12-01

Chlamydia trachomatis infection constitutes the most common sexual transmitted disease (STD) among young women. International studies demonstrate that prevalence changes over time and also according to places. To estimate the prevalence of this infection among asymptomatic Chilean women (15 to 24 years old) and correlating with risk factor occurrence. Transversal cohort study to identify C. trachomatis infection through a diagnostic kit designed to detect and amplify cryptic plasmid DNA by quantitative PCR from endocervical sample. 181 women were screened during the period of study. The overall prevalence estimate was 5.5% and founding significant estimate variations (0% to 14.6%) between recruiting centers. There was difference in number of sexual partners (4.1 vs 2.5; p<0.05) between positive and negative women. No difference was observed in age of first coitus, STD history, the use of barrier method or socioeconomic level. However, the probability of being carrier increases as greater is the number of sexual partners, especially when the use of barrier method is low. The latest is not related to the socioeconomic level. One of 12 to 18 women at this age range will have asymptomatic infection. The current prevalence and its variability substantiates the C. trachomatis screening and periodic surveillance.

West Nile virus surveillance in Europe: moving towards an integrated animal-human-vector approach

PubMed Central

Gossner, Céline M; Marrama, Laurence; Carson, Marianne; Allerberger, Franz; Calistri, Paolo; Dilaveris, Dimitrios; Lecollinet, Sylvie; Morgan, Dilys; Nowotny, Norbert; Paty, Marie-Claire; Pervanidou, Danai; Rizzo, Caterina; Roberts, Helen; Schmoll, Friedrich; Van Bortel, Wim; Gervelmeyer, Andrea

2017-01-01

This article uses the experience of five European countries to review the integrated approaches (human, animal and vector) for surveillance and monitoring of West Nile virus (WNV) at national and European levels. The epidemiological situation of West Nile fever in Europe is heterogeneous. No model of surveillance and monitoring fits all, hence this article merely encourages countries to implement the integrated approach that meets their needs. Integration of surveillance and monitoring activities conducted by the public health authorities, the animal health authorities and the authorities in charge of vector surveillance and control should improve efficiency and save resources by implementing targeted measures. The creation of a formal interagency working group is identified as a crucial step towards integration. Blood safety is a key incentive for public health authorities to allocate sufficient resources for WNV surveillance, while the facts that an effective vaccine is available for horses and that most infected animals remain asymptomatic make the disease a lesser priority for animal health authorities. The examples described here can support other European countries wishing to strengthen their WNV surveillance or preparedness, and also serve as a model for surveillance and monitoring of other (vector-borne) zoonotic infections. PMID:28494844

Hospital- and community-associated methicillin-resistant Staphylococcus aureus: a 6-year surveillance study of invasive infections in Chinese children.

PubMed

Qiao, Yanhong; Dong, Fang; Song, Wenqi; Wang, Lijuan; Yang, Yonghong; Shen, Xuzhuang

2013-11-01

To investigate and compare the characteristics of invasive hospital-associated (HA) and community-associated (CA) methicillin-resistant Staphylococcus aureus (MRSA) infections in Chinese children. Clinical data on 59 paediatric patients with invasive MRSA isolated from the normally sterile sites between 2006 and 2011 were obtained from the clinical MRSA surveillance database of Beijing Children's Hospital. The molecular characteristics of the invasive MRSA strains were then analysed. Invasive MRSA infections rose from 0.89 per 10 000 admissions in 2006 to 3.75 in 2011, with a notable increase in invasive CA-MRSA infections from 0 to 2.43 over the same period. The median age of the CA patients (n = 29) was 0.33 years, compared with 1.17 years for the HA patients (n = 30). Multisite infection, severe pneumonia and empyema were found in 55.2%, 73.1% and 61.5% of CA children and in 30%, 32% and 24% of HA patients, respectively. ST59-MRSA-IVa accounted for 40.7% of all isolates and the Panton-Valentine leukocidin (PVL) gene carriage rate was significantly higher in patients with necrotizing pneumonia and osteoarthritis than in those with other diseases. The incidence of paediatric invasive MRSA infection, particularly CA-MRSA infection, increased in Chinese children between 2006 and 2011. The invasive infections caused by CA-MRSA occurred more frequently in younger children with more severe pneumonia or empyema. ©2013 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Lyssavirus Surveillance in Bats, Bangladesh

PubMed Central

Niezgoda, Michael; Carroll, Darin S.; Keeler, Natalie; Hossain, Mohammed Jahangir; Breiman, Robert F.; Ksiazek, Thomas G.; Rupprecht, Charles E.

2006-01-01

Lyssavirus surveillance in bats was performed in Bangladesh during 2003 and 2004. No virus isolates were obtained. Three serum samples (all from Pteropus giganteus, n = 127) of 288 total serum samples, obtained from bats in 9 different taxa, neutralized lyssaviruses Aravan and Khujand. The infection occurs in bats in Bangladesh, but virus prevalence appears low. PMID:16704789

Ebola Surveillance - Guinea, Liberia, and Sierra Leone.

PubMed

McNamara, Lucy A; Schafer, Ilana J; Nolen, Leisha D; Gorina, Yelena; Redd, John T; Lo, Terrence; Ervin, Elizabeth; Henao, Olga; Dahl, Benjamin A; Morgan, Oliver; Hersey, Sara; Knust, Barbara

2016-07-08

Developing a surveillance system during a public health emergency is always challenging but is especially so in countries with limited public health infrastructure. Surveillance for Ebola virus disease (Ebola) in the West African countries heavily affected by Ebola (Guinea, Liberia, and Sierra Leone) faced numerous impediments, including insufficient numbers of trained staff, community reticence to report cases and contacts, limited information technology resources, limited telephone and Internet service, and overwhelming numbers of infected persons. Through the work of CDC and numerous partners, including the countries' ministries of health, the World Health Organization, and other government and nongovernment organizations, functional Ebola surveillance was established and maintained in these countries. CDC staff were heavily involved in implementing case-based surveillance systems, sustaining case surveillance and contact tracing, and interpreting surveillance data. In addition to helping the ministries of health and other partners understand and manage the epidemic, CDC's activities strengthened epidemiologic and data management capacity to improve routine surveillance in the countries affected, even after the Ebola epidemic ended, and enhanced local capacity to respond quickly to future public health emergencies. However, the many obstacles overcome during development of these Ebola surveillance systems highlight the need to have strong public health, surveillance, and information technology infrastructure in place before a public health emergency occurs. Intense, long-term focus on strengthening public health surveillance systems in developing countries, as described in the Global Health Security Agenda, is needed.The activities summarized in this report would not have been possible without collaboration with many U.S and international partners (http://www.cdc.gov/vhf/ebola/outbreaks/2014-west-africa/partners.html).

Surveillance of vector-borne diseases in Germany: trends and challenges in the view of disease emergence and climate change.

PubMed

Jansen, Andreas; Frank, Christina; Koch, Judith; Stark, Klaus

2008-12-01

The changing epidemiology of vector-borne diseases represents a growing threat to human health. Contemporary surveillance systems have to adapt to these changes. We describe temporal trends and geographic origins of vector-borne diseases in Germany with regard to strengths of existing disease surveillance and to areas marked for improvement. We focused on hantavirus infection (endemic in Germany), chikungunya fever (recently emerging in Europe) and dengue fever (imported from tropical regions), representing important subgroups of vector-borne infections. Routine surveillance data on demographics, origin of infection and the date of reporting were analysed. From 2001 through 2007, 3,005 symptomatic hantavirus infections, and 85 cases of chikungunya fever were reported, similarly 1,048 cases of dengue fever in 2002 through 2007. The geographic origin of hantavirus infection was reported for 95.5% of all cases (dengue virus, 98.4%; chikungunya virus, 100%). Hantavirus infections were acquired in Germany in 97.6% of cases (n = 2800). In 2007, there was a marked increase of hantavirus cases, mainly in areas known to be endemic for hantavirus. In 2006, imported cases of chikungunya fever primarily returned from several islands of the Indian Ocean, while the majority of imported cases in 2007 came from India. The reported number of dengue fever cases have increased since 2004. Thailand contributed the largest proportion of cases (17-43% in individual years), followed by India, Brazil and Indonesia. Surveillance of notifiable vector-borne diseases in Germany is able to timely detect spatial and temporal changes of autochthonous an imported infections. Geographic and temporal data obtained by routine surveillance served as a basis for public health recommendations. In addition to surveillance of vector-borne infections in humans, nationwide monitoring programs and inventory techniques for emerging and reemerging vectors and for wildlife disease are warranted.

10 years of surveillance of human tularaemia in France.

PubMed

Mailles, A; Vaillant, V

2014-11-13

Tularaemia has been mandatorily notifiable in France since October 2002. The surveillance aims to detect early any infection possibly due to bioterrorism and to follow up disease trends. We report the results of national surveillance from 2002 to 2012. A case is defined as a patient with clinical presentation suggestive of tularaemia and biological confirmation of infection or an epidemiological link with a biologically confirmed case. Clinical, biological and epidemiological data are collected using a standardised notification form. From 2002 to 2012, 433 cases were notified, with a median age of 49 years (range 2 to 95 years) and a male–female sex ratio of 1.8. Most frequent clinical presentations were glandular tularaemia (n=200; 46%) and ulceroglandular tularaemia (n=113; 26%). Most frequent at-risk exposures were handling hares (n=179; 41%) and outdoor leisure exposure to dust aerosols (n=217; 50%). Tick bites were reported by 82 patients (19%). Ten clusters (39 cases) were detected over the 10-year period, as well as a national outbreak during winter 2007/2008. The tularaemia surveillance system is able to detect small clusters as well as major outbreaks. Surveillance data show exposure to dust aerosols during outdoor leisure activities to be a major source of contamination in France.

Case based rubella surveillance in Abia State, South East Nigeria, 2007–2011

PubMed Central

Umeh, Chukwuemeka Anthony

2014-01-01

Introduction. Rubella infection has the potential of causing severe fetal birth defects collectively called congenital rubella syndrome (CRS) if the mother is infected early in pregnancy. However, little is known about rubella and CRS epidemiology in Nigeria and rubella vaccines are still not part of routine childhood immunization in Nigeria. Methods. Analysis of confirmed cases of rubella in Abia State, Nigeria from 2007 to 2011 detected through Abia State Integrated Disease Surveillance and Response system. Results. Of the 757 febrile rash cases, 81(10.7%) tested positive for rubella immunoglobulin M (IgM). New rubella infection decreased from 6.81/1,000,000 population in 2007 to 2.28/1,000,000 in 2009 and increased to 6.34/1,000,000 in 2011. The relative risk of rubella was 1.5 (CI [0.98–2.28]) times as high in females compared to males and 1.6 times (CI [0.90–2.91]) as high in rural areas compared to urban areas. Eighty six percent of rubella infections occurred in children less than 15 years with a high proportion of cases occurring between 5 and 14 years. Conclusion. Rubella infection in Abia State, Nigeria is predominantly in those who are younger than 15 years old. It is also more prevalent in females and in those living in rural areas of the state. Unfortunately, there is no surveillance of CRS in Nigeria and so the public health impact of rubella infection in the state is not known. Efforts should be made to expand the rubella surveillance in Nigeria to incorporate surveillance for CRS. PMID:25289179

[Microbiological surveillance in an intensive care unit of a large Roman hospital].

PubMed

Franchi, Cristiana; Venditti, Mario; Rocco, Monica; Spadetta, Gustavo; Vullo, Vincenzo; Raponi, Massimiliano; Orsi, Giovanni Battista

2002-06-01

Infection surveillance in ICU is fundamental to monitor endemic rates, to identify outbreaks on-time in order to activate control procedures implementing a correct empirical antibiotic treatment. The data collection surveillance software CIN-20002 was established in the Teaching Hospital Umberto I ICU to monitor the following site-specific infection rates: urinary tract infections (UTI), pneumonia (PNE), blood stream infections (BSI), surgical site infections (SSI). According to CDC definitions all patients developing infection 48 hours or more after ward admission were included. Furthermore risk factors (i.e. age, sex, SAPS II), invasive procedures (i.e. endotracheal intubation, vascular and urinary catheterisation), microbiological isolates and their antibiotic susceptibility were screened. Overall 279 patients (183 men and 96 women) were admitted; age 54,8 20,3 years (mean), SAPS II 44,4 17,1 (mean) and average ward stay 13,3 17,8 days. Results showed a total of 121 infection episodes (56 PNE, 51 BSI, 10 UTI e 4 SSI) in 80 patients (28,7%). Standardized infection rates associated to invasive procedures were: Urinary catheter-associated UTI rate (2.9/1000), Ventilator-associated PNE rate (20.4/1000), Vascular catheter-associated BSI rate (19.1/1000). Among the infected patients the most common microrganisms isolated were P. aeruginosa (31,8%), MRSA (14,8%), A. baumanni (12,5%) e S. maltophilia (8,5%). Considering site-specific infections: PNE (P. aeruginosa 38,3% and MRSA 18,1%), BSI (MR CNS 21,9% and P. aeruginosa 17,2%), UTI (P. aeruginosa 70,0%). The surveillance software CIN-2000 proved to be very accurate, usefull and easy to use. The results showed a high incidence of infections associated to invasive procedures and the presence of multiresistant bacteria

Surveillance of vector-borne pathogens under imperfect detection: lessons from Chagas disease risk (mis)measurement.

PubMed

Minuzzi-Souza, Thaís Tâmara Castro; Nitz, Nadjar; Cuba, César Augusto Cuba; Hagström, Luciana; Hecht, Mariana Machado; Santana, Camila; Ribeiro, Marcelle; Vital, Tamires Emanuele; Santalucia, Marcelo; Knox, Monique; Obara, Marcos Takashi; Abad-Franch, Fernando; Gurgel-Gonçalves, Rodrigo

2018-01-09

Vector-borne pathogens threaten human health worldwide. Despite their critical role in disease prevention, routine surveillance systems often rely on low-complexity pathogen detection tests of uncertain accuracy. In Chagas disease surveillance, optical microscopy (OM) is routinely used for detecting Trypanosoma cruzi in its vectors. Here, we use replicate T. cruzi detection data and hierarchical site-occupancy models to assess the reliability of OM-based T. cruzi surveillance while explicitly accounting for false-negative and false-positive results. We investigated 841 triatomines with OM slides (1194 fresh, 1192 Giemsa-stained) plus conventional (cPCR, 841 assays) and quantitative PCR (qPCR, 1682 assays). Detections were considered unambiguous only when parasitologists unmistakably identified T. cruzi in Giemsa-stained slides. qPCR was >99% sensitive and specific, whereas cPCR was ~100% specific but only ~55% sensitive. In routine surveillance, examination of a single OM slide per vector missed ~50-75% of infections and wrongly scored as infected ~7% of the bugs. qPCR-based and model-based infection frequency estimates were nearly three times higher, on average, than OM-based indices. We conclude that the risk of vector-borne Chagas disease may be substantially higher than routine surveillance data suggest. The hierarchical modelling approach we illustrate can help enhance vector-borne disease surveillance systems when pathogen detection is imperfect.

CRISPR-Cas type I-A Cascade complex couples viral infection surveillance to host transcriptional regulation in the dependence of Csa3b

PubMed Central

He, Fei; Vestergaard, Gisle; Peng, Wenfang; She, Qunxin

2017-01-01

Abstract CRISPR-Cas (clustered regularly interspaced short palindromic repeats and the associated genes) constitute adaptive immune systems in bacteria and archaea and they provide sequence specific immunity against foreign nucleic acids. CRISPR-Cas systems are activated by viral infection. However, little is known about how CRISPR-Cas systems are activated in response to viral infection or how their expression is controlled in the absence of viral infection. Here, we demonstrate that both the transcriptional regulator Csa3b, and the type I-A interference complex Cascade, are required to transcriptionally repress the interference gene cassette in the archaeon Sulfolobus. Csa3b binds to two palindromic repeat sites in the promoter region of the cassette and facilitates binding of the Cascade to the promoter region. Upon viral infection, loading of Cascade complexes onto crRNA-matching protospacers leads to relief of the transcriptional repression. Our data demonstrate a mechanism coupling CRISPR-Cas surveillance of protospacers to transcriptional regulation of the interference gene cassette thereby allowing a fast response to viral infection. PMID:27980065

The Acceptability and Feasibility of Implementing a Bio-Behavioral Enhanced Surveillance Tool for Sexually Transmitted Infections in England: Mixed-Methods Study.

PubMed

Wayal, Sonali; Reid, David; Blomquist, Paula B; Weatherburn, Peter; Mercer, Catherine H; Hughes, Gwenda

2018-05-04

Sexually transmitted infection (STI) surveillance is vital for tracking the scale and pattern of epidemics; however, it often lacks data on the underlying drivers of STIs. This study aimed to assess the acceptability and feasibility of implementing a bio-behavioral enhanced surveillance tool, comprising a self-administered Web-based survey among sexual health clinic attendees, as well as linking this to their electronic health records (EHR) held in England's national STI surveillance system. Staff from 19 purposively selected sexual health clinics across England and men who have sex with men and black Caribbeans, because of high STI burden among these groups, were interviewed to assess the acceptability of the proposed bio-behavioral enhanced surveillance tool. Subsequently, sexual health clinic staff invited all attendees to complete a Web-based survey on drivers of STI risk using a study tablet or participants' own digital device. They recorded the number of attendees invited and participants' clinic numbers, which were used to link survey data to the EHR. Participants' online consent was obtained, separately for survey participation and linkage. In postimplementation phase, sexual health clinic staff were reinterviewed to assess the feasibility of implementing the bio-behavioral enhanced surveillance tool. Acceptability and feasibility of implementing the bio-behavioral enhanced surveillance tool were assessed by analyzing these qualitative and quantitative data. Prior to implementation of the bio-behavioral enhanced surveillance tool, sexual health clinic staff and attendees emphasized the importance of free internet/Wi-Fi access, confidentiality, and anonymity for increasing the acceptability of the bio-behavioral enhanced surveillance tool among attendees. Implementation of the bio-behavioral enhanced surveillance tool across sexual health clinics varied considerably and was influenced by sexual health clinics' culture of prioritization of research and

Measuring mechanisms for quality assurance in primary care systems in transition: test of a new instrument in Slovenia and Uzbekistan.

PubMed

Kringos, Dionne Sofia; Boerma, Wienke; Pellny, Martina

2009-01-01

This World Health Organization (WHO) study aimed to develop and field test an instrument to assess the availability of structures and mechanisms for managing quality in primary care in countries in transition. The instrument is based on a literature study, consensus meetings with experts, and observations in these countries. It consists of three parts: a semi-structured questionnaire on national policies and mechanisms; a structured questionnaire for general practitioners (GPs); and a structured questionnaire for use with managers of primary care facilities. The instrument has been field tested in 2007 in Slovenia and Uzbekistan. In Slovenia, leadership on quality improvement was weak and local managers reported few incentives and resources to control quality. There was a lack of external support for quality improvement activities. Availability and use of clinical guidelines for GPs were not optimal. GPs found teamwork and communication with patients inadequate. In Uzbekistan, primary care quality and standards in health centres were extensively regulated and laid down in numerous manuals, instructions and other documents. Managers, however, indicated the need for more financial and non-financial levers for quality improvement and they wanted to know more about modern healthcare management. GPs reported strong involvement in activities such as peer review and clinical audit, and reported frequent use of clinical guidelines. Overall, the information gathered with the provisional instrument has resulted in policy recommendations. At the same time, the pilot resulted in improvements to the instrument. Application of the instrument helps decision makers to identify improvement areas in the infrastructure for managing the quality of primary care.

Cross-Sectional HIV Incidence Surveillance: A Benchmarking of Approaches for Estimating the 'Mean Duration of Recent Infection'.

PubMed

Kassanjee, Reshma; De Angelis, Daniela; Farah, Marian; Hanson, Debra; Labuschagne, Jan Phillipus Lourens; Laeyendecker, Oliver; Le Vu, Stéphane; Tom, Brian; Wang, Rui; Welte, Alex

2017-03-01

The application of biomarkers for 'recent' infection in cross-sectional HIV incidence surveillance requires the estimation of critical biomarker characteristics. Various approaches have been employed for using longitudinal data to estimate the Mean Duration of Recent Infection (MDRI) - the average time in the 'recent' state. In this systematic benchmarking of MDRI estimation approaches, a simulation platform was used to measure accuracy and precision of over twenty approaches, in thirty scenarios capturing various study designs, subject behaviors and test dynamics that may be encountered in practice. Results highlight that assuming a single continuous sojourn in the 'recent' state can produce substantial bias. Simple interpolation provides useful MDRI estimates provided subjects are tested at regular intervals. Regression performs the best - while 'random effects' describe the subject-clustering in the data, regression models without random effects proved easy to implement, stable, and of similar accuracy in scenarios considered; robustness to parametric assumptions was improved by regressing 'recent'/'non-recent' classifications rather than continuous biomarker readings. All approaches were vulnerable to incorrect assumptions about subjects' (unobserved) infection times. Results provided show the relationships between MDRI estimation performance and the number of subjects, inter-visit intervals, missed visits, loss to follow-up, and aspects of biomarker signal and noise.

The role of supplementary environmental surveillance to complement acute flaccid paralysis surveillance for wild poliovirus in Pakistan – 2011–2013

PubMed Central

Burns, Cara C.; Sharif, Salmaan; Gary, Howard E.; Iber, Jane; Henderson, Elizabeth; Malik, Farzana; Zahoor Zaidi, Syed Sohail; Shaukat, Shahzad; Rehman, Lubna; Pallansch, Mark A.; Orenstein, Walter A.

2017-01-01

Background More than 99% of poliovirus infections are non-paralytic and therefore, not detected by acute flaccid paralysis (AFP) surveillance. Environmental surveillance (ES) can detect circulating polioviruses from sewage without relying on clinical presentation. With extensive ES and continued circulation of polioviruses, Pakistan presents a unique opportunity to quantify the impact of ES as a supplement to AFP surveillance on overall completeness and timeliness of poliovirus detection. Methods Genetic, geographic and temporal data were obtained for all wild poliovirus (WPV) isolates detected in Pakistan from January 2011 through December 2013. We used viral genetics to assess gaps in AFP surveillance and ES as measured by detection of ‘orphan viruses’ (≥1.5% different in VP1 capsid nucleotide sequence). We compared preceding detection of closely related circulating isolates (≥99% identity) detected by AFP surveillance or ES to determine which surveillance system first detected circulation before the presentation of each polio case. Findings A total of 1,127 WPV isolates were detected by AFP surveillance and ES in Pakistan from 2011–2013. AFP surveillance and ES combined exhibited fewer gaps (i.e., % orphan viruses) in detection than AFP surveillance alone (3.3% vs. 7.7%, respectively). ES detected circulation before AFP surveillance in nearly 60% of polio cases (200 of 346). For polio cases reported from provinces conducting ES, ES detected circulation nearly four months sooner on average (117.6 days) than did AFP surveillance. Interpretation Our findings suggest ES in Pakistan is providing earlier, more sensitive detection of wild polioviruses than AFP surveillance alone. Overall, targeted ES through strategic selection of sites has important implications in the eradication endgame strategy. PMID:28742803

Enhancing surveillance for hepatitis C through public health informatics.

PubMed

Heisey-Grove, Dawn M; Church, Daniel R; Haney, Gillian A; Demaria, Alfred

2011-01-01

Disease surveillance for hepatitis C in the United States is limited by the occult nature of many of these infections, the large volume of cases, and limited public health resources. Through a series of discrete processes, the Massachusetts Department of Public Health modified its surveillance system in an attempt to improve timeliness and completeness of reporting and case follow-up of hepatitis C. These processes included clinician-based reporting, electronic laboratory reporting, deployment of a Web-based disease surveillance system, automated triage of pertinent data, and automated character recognition software for case-report processing. These changes have resulted in an increase in the timeliness of reporting.

Retrospective Surveillance of Wastewater To Examine Seasonal Dynamics of Enterovirus Infections

PubMed Central

Fout, G. Shay; Keely, Scott P.

2017-01-01

ABSTRACT Enteroviruses are RNA viruses that are responsible for both mild gastroenteritis and mild respiratory illnesses as well as debilitating diseases such as meningitis and myocarditis. The disease burden of enteroviruses in the United States is difficult to assess because most infections are not recorded. Since infected individuals shed enterovirus in feces and urine, surveillance of municipal wastewater can reveal the diversity of enteroviruses circulating in human populations. Therefore, monthly municipal wastewater samples were collected for 1 year and enteroviruses were quantified by reverse transcriptase quantitative PCR and identified by next-generation, high-throughput sequencing. Enterovirus concentrations ranged from 3.8 to 5.9 log10 equivalent copies/liter in monthly samples. From the mean monthly concentration, it can be estimated that 2.8% of the contributing population was shedding enterovirus daily. Sequence analysis showed that Enterovirus A and Enterovirus B alternate in predominance, with Enterovirus B comprising over 80% of the reads during the summer and fall months and Enterovirus A accounting for >45% of the reads in spring. Enterovirus C was observed throughout the year, while Enterovirus D was present intermittently. Principal-component analysis further supported the date corresponding to enterovirus seasonal trends as CVA6 (Enterovirus A) was predominant in the spring months; CVB3, CVB5, and E9 (Enterovirus B) were predominant in the summer and fall months; and CVA1, CVA19, and CVA22 (Enterovirus C) and EV97 (Enterovirus B) were predominant in winter. Rhinoviruses were also observed. Wastewater monitoring of human enterovirus provided improved insight into the seasonal patterns of enteroviruses circulating in communities and can contribute to understanding of enterovirus disease burden. IMPORTANCE Enterovirus infections are often not tracked or reported to health officials. This makes it hard to know how many people in a community are

West Nile virus surveillance in Europe: moving towards an integrated animal-human-vector approach.

PubMed

Gossner, Céline M; Marrama, Laurence; Carson, Marianne; Allerberger, Franz; Calistri, Paolo; Dilaveris, Dimitrios; Lecollinet, Sylvie; Morgan, Dilys; Nowotny, Norbert; Paty, Marie-Claire; Pervanidou, Danai; Rizzo, Caterina; Roberts, Helen; Schmoll, Friedrich; Van Bortel, Wim; Gervelmeyer, Andrea

2017-05-04

This article uses the experience of five European countries to review the integrated approaches (human, animal and vector) for surveillance and monitoring of West Nile virus (WNV) at national and European levels. The epidemiological situation of West Nile fever in Europe is heterogeneous. No model of surveillance and monitoring fits all, hence this article merely encourages countries to implement the integrated approach that meets their needs. Integration of surveillance and monitoring activities conducted by the public health authorities, the animal health authorities and the authorities in charge of vector surveillance and control should improve efficiency and save resources by implementing targeted measures. The creation of a formal interagency working group is identified as a crucial step towards integration. Blood safety is a key incentive for public health authorities to allocate sufficient resources for WNV surveillance, while the facts that an effective vaccine is available for horses and that most infected animals remain asymptomatic make the disease a lesser priority for animal health authorities. The examples described here can support other European countries wishing to strengthen their WNV surveillance or preparedness, and also serve as a model for surveillance and monitoring of other (vector-borne) zoonotic infections. This article is copyright of The Authors, 2017.

Advanced Molecular Surveillance of Hepatitis C Virus

PubMed Central

Gonçalves Rossi, Livia Maria; Escobar-Gutierrez, Alejandro; Rahal, Paula

2015-01-01

Hepatitis C virus (HCV) infection is an important public health problem worldwide. HCV exploits complex molecular mechanisms, which result in a high degree of intrahost genetic heterogeneity. This high degree of variability represents a challenge for the accurate establishment of genetic relatedness between cases and complicates the identification of sources of infection. Tracking HCV infections is crucial for the elucidation of routes of transmission in a variety of settings. Therefore, implementation of HCV advanced molecular surveillance (AMS) is essential for disease control. Accounting for virulence is also important for HCV AMS and both viral and host factors contribute to the disease outcome. Therefore, HCV AMS requires the incorporation of host factors as an integral component of the algorithms used to monitor disease occurrence. Importantly, implementation of comprehensive global databases and data mining are also needed for the proper study of the mechanisms responsible for HCV transmission. Here, we review molecular aspects associated with HCV transmission, as well as the most recent technological advances used for virus and host characterization. Additionally, the cornerstone discoveries that have defined the pathway for viral characterization are presented and the importance of implementing advanced HCV molecular surveillance is highlighted. PMID:25781918

Central line-associated bloodstream infections in adult hematology patients with febrile neutropenia: an evaluation of surveillance definitions using differential time to blood culture positivity.

PubMed

Freeman, Joshua T; Elinder-Camburn, Anna; McClymont, Catherine; Anderson, Deverick J; Bilkey, Mary; Williamson, Deborah A; Berkahn, Leanne; Roberts, Sally A

2013-01-01

We used differential time to positivity between central and peripheral blood cultures to evaluate the positive predictive value (PPV) of the National Healthcare Safety Network central line-associated bloodstream infection (CLABSI) surveillance definition among hematology patients with febrile neutropenia. The PPV was 27.7%, which suggests that, when the definition is applied to this population, CLABSI rates will be substantially overestimated.

Cost-effectiveness evaluation of bovine tuberculosis surveillance in wildlife in France (Sylvatub system) using scenario trees.

PubMed

Rivière, Julie; Le Strat, Yann; Hendrikx, Pascal; Dufour, Barbara

2017-01-01

Bovine tuberculosis (bTB) is a common disease in cattle and wildlife, with health, zoonotic and economic implications. Infected wild animals, and particularly reservoirs, could hinder eradication of bTB from cattle populations, which could have an important impact on international cattle trade. Therefore, surveillance of bTB in wildlife is of particular importance to better understand the epidemiological role of wild species and to adapt the control measures. In France, a bTB surveillance system for free-ranging wildlife, the Sylvatub system, has been implemented since 2011. It relies on three surveillance components (SSCs) (passive surveillance on hunted animals (EC-SSC), passive surveillance on dead or dying animals (SAGIR-SSC) and active surveillance (PSURV-SSC)). The effectiveness of the Sylvatub system was previously assessed, through the estimation of its sensitivity (i.e. the probability of detecting at least one case of bTB infection by each SSC, specie and risk-level area). However, to globally assess the performance of a surveillance system, the measure of its sensitivity is not sufficient, as other factors such as economic or socio-economic factors could influence the effectiveness. We report here an estimation of the costs of the surveillance activities of the Sylvatub system, and of the cost-effectiveness of each surveillance component, by specie and risk-level, based on scenario tree modelling with the same tree structure as used for the sensitivity evaluation. The cost-effectiveness of the Sylvatub surveillance is better in higher-risk departments, due in particular to the higher probability of detecting the infection (sensitivity). Moreover, EC-SSC, which has the highest unit cost, is more efficient than the surveillance enhanced by the SAGIR-SSC, due to its better sensitivity. The calculation of the cost-effectiveness ratio shows that PSURV-SSC remains the most cost-effective surveillance component of the Sylvatub system, despite its high cost in

Cost-effectiveness evaluation of bovine tuberculosis surveillance in wildlife in France (Sylvatub system) using scenario trees

PubMed Central

2017-01-01

Bovine tuberculosis (bTB) is a common disease in cattle and wildlife, with health, zoonotic and economic implications. Infected wild animals, and particularly reservoirs, could hinder eradication of bTB from cattle populations, which could have an important impact on international cattle trade. Therefore, surveillance of bTB in wildlife is of particular importance to better understand the epidemiological role of wild species and to adapt the control measures. In France, a bTB surveillance system for free-ranging wildlife, the Sylvatub system, has been implemented since 2011. It relies on three surveillance components (SSCs) (passive surveillance on hunted animals (EC-SSC), passive surveillance on dead or dying animals (SAGIR-SSC) and active surveillance (PSURV-SSC)). The effectiveness of the Sylvatub system was previously assessed, through the estimation of its sensitivity (i.e. the probability of detecting at least one case of bTB infection by each SSC, specie and risk-level area). However, to globally assess the performance of a surveillance system, the measure of its sensitivity is not sufficient, as other factors such as economic or socio-economic factors could influence the effectiveness. We report here an estimation of the costs of the surveillance activities of the Sylvatub system, and of the cost-effectiveness of each surveillance component, by specie and risk-level, based on scenario tree modelling with the same tree structure as used for the sensitivity evaluation. The cost-effectiveness of the Sylvatub surveillance is better in higher-risk departments, due in particular to the higher probability of detecting the infection (sensitivity). Moreover, EC-SSC, which has the highest unit cost, is more efficient than the surveillance enhanced by the SAGIR-SSC, due to its better sensitivity. The calculation of the cost-effectiveness ratio shows that PSURV-SSC remains the most cost-effective surveillance component of the Sylvatub system, despite its high cost in

Decrease in Staphylococcus aureus colonization and hospital-acquired infection in a medical intensive care unit after institution of an active surveillance and decolonization program.

PubMed

Fraser, Thomas G; Fatica, Cynthia; Scarpelli, Michele; Arroliga, Alejandro C; Guzman, Jorge; Shrestha, Nabin K; Hixson, Eric; Rosenblatt, Miriam; Gordon, Steven M; Procop, Gary W

2010-08-01

To evaluate the effects of an active surveillance program for Staphylococcus aureus linked to a decolonization protocol on the incidence of healthcare-associated infection and new nasal colonization due to S. aureus. Retrospective quasi-experimental study. An 18-bed medical intensive care unit at a tertiary care center in Cleveland, Ohio. From January 1, 2006, through December 31, 2007, all patients in the medical intensive care unit were screened for S. aureus nasal carriage at admission and weekly thereafter. During the preintervention period, January 1 through September 30, 2006, only surveillance occurred. During the intervention period, January 1 through December 31, 2007, S. aureus carriers received mupirocin intranasally. Beginning in February 2007, carriers also received chlorhexidine gluconate baths. During the preintervention period, 604 (73.7%) of 819 patients were screened for S. aureus nasal carriage, yielding 248 prevalent carriers (30.3%). During the intervention period, 752 (78.3%) of 960 patients were screened, yielding 276 carriers (28.8%). The incidence of S. aureus carriage decreased from 25 cases in 3,982 patient-days (6.28 cases per 1,000 patient-days) before intervention to 18 cases in 5,415 patient-days (3.32 cases per 1,000 patient-days) (P=.04; relative risk [RR], 0.53 [95% confidence interval {CI}, 0.28-0.97]) and from 9.57 to 4.77 cases per 1,000 at-risk patient-days (P=.02; RR, 0.50 [95% CI, 0.27-0.91]). The incidence of S. aureus hospital-acquired bloodstream infection during the 2 periods was 2.01 and 1.11 cases per 1,000 patient-days, respectively (P=.28). The incidence of S. aureus ventilator-associated pneumonia decreased from 1.51 to 0.18 cases per 1,000 patient-days (P=.03; RR, 0.12 [95% CI, 0.01-0.83]). The total incidence of S. aureus hospital-acquired infection decreased from 3.52 to 1.29 cases per 1,000 patient-days (P=.03; RR, 0.37 [95% CI, 0.14-0.90]). Active surveillance for S. aureus nasal carriage combined with

[Antibiotic consumption surveillance - state of implementation in Munich hospitals : Latest survey by the Munich public health department on the implementation of § 23 Infection protection act].

PubMed

Otto, Cornelia; Hirl, Bertrand; Schweitzer, Stefan; Gleich, Sabine

2016-12-01

On 4 August 2011 a modification of the infection protection act became law, meaning that antibiotic consumption surveillance and evaluation of data on the local resistance situation became obligatory for hospitals. Four years after the modification of the infection protection act became law, the Munich public health department aimed to evaluate the state of implementation of antibiotic consumption surveillance in Munich hospitals and to ascertain which antibiotic stewardship (ABS) structures have already been established. A questionnaire was sent to Munich hospitals about their antibiotic management structural data and state of implementation of legal requirements. Only 32 % of the hospitals have qualified ABS-experts available. In 76 % of the hospitals persons responsible for antibiotic consumption surveillance are appointed, while in 12 % persons responsible for antibiotic consumption surveillance are at least partly released from their normal work for this activity. Twenty-one hospitals (21 %) conduct antibiotic consumption surveillance taking into account all antiinfective agents mentioned in the Robert Koch-Institute (RKI) guidelines. Of these, 19 (76 %) did this on basis of World Health Organizations ATC/DDD-system (anatomical therapeutic chemical [ATC] classification system which uses defined daily doses [DDD]). The data on antibiotic consumption is evaluated in 72 % of the hospitals, 68 % take account of the local resistance situation. In 96 %, in-house lists of antiinfectives are available; in 80 %, in-house guidelines for antibiotic treatment are available. Fourty-four percent of the hospitals take part in a national surveillance. For the first time data were collected on implementation of antibiotic consumption surveillance in hospitals, which has been required by law since 2011. An incomplete implementation of legal requirements was demonstrated. It was found that structural and personnel prerequisites are often missing, that

Clinical, Bacteriologic, and Geographic Stratification of Melioidosis Emerges from the Sri Lankan National Surveillance Program.

PubMed

Sathkumara, Harindra D; Merritt, Adam J; Corea, Enoka M; Krishnananthasivam, Shivankari; Natesan, Mohan; Inglis, Timothy J J; De Silva, Aruna Dharshan

2018-02-01

Melioidosis, a potentially fatal tropical infection, is said to be underdiagnosed in low-income countries. An increase in melioidosis cases in Sri Lanka allowed us to analyze the relationship among clinical outcome, bacteriology, epidemiology, and geography in the first 108 laboratory-confirmed cases of melioidosis from a nationwide surveillance program. The additional 76 cases of laboratory-confirmed melioidosis confirmed further associations between Burkholderia pseudomallei multilocus sequence typing (MLST) and infection phenotype; ST1137/unifocal bacteremic infection (χ 2 = 3.86, P < 0.05), ST1136/multifocal infection without bacteremia (χ 2 = 15.8, P < 0.001), and ST1132/unifocal nonbacteremic infection (χ 2 = 6.34, P = 0.02). ST1137 infections were predominantly seen in the Western Province, whereas ST1132, 1135, and 1136 infections predominated in the Northwestern Province. Early participating centers in the surveillance program had a lower melioidosis-associated mortality than later participants (χ 2 = 3.99, P < 0.05). The based upon related sequence types (eBURST) algorithm, a MLST clustering method that infers founding genotypes and patterns of descent for related isolates and clonal complexes in an unrooted tree, showed uneven distribution of sequence types (STs). There was spatial clustering of the commonest STs (ST1132, 1136, and 1137) in the Western, Northwestern, and Central provinces. The recent increase in melioidosis in Sri Lanka uncovered by laboratory-enhanced surveillance is likely to be the result of a combination of improved laboratory detection, increased clinician awareness, recruitment of clinical centers, and small outbreaks. Further development of the surveillance program into a national genotyping-supported melioidosis registry will improve melioidosis diagnosis, treatment, and prevention where underdiagnosis and mortality rates remain high.

Surveillance of pneumococcal diseases in Central and Eastern Europe.

PubMed

Ceyhan, Mehmet; Dagan, Ron; Sayiner, Abdullah; Chernyshova, Liudmyla; Dinleyici, Ener Çağrı; Hryniewicz, Waleria; Kulcsár, Andrea; Mad'arová, Lucia; Pazdiora, Petr; Sidorenko, Sergey; Streinu-Cercel, Anca; Tambić-Andrašević, Arjana; Yeraliyeva, Lyazzat

2016-08-02

Pneumococcal infection is a major cause of morbidity and mortality worldwide. The burden of disease associated with S. pneumoniae is largely preventable through routine vaccination. Pneumococcal conjugate vaccines (e.g. PCV7, PCV13) provide protection from invasive pneumococcal disease as well as non-invasive infection (pneumonia, acute otitis media), and decrease vaccine-type nasopharyngeal colonisation, thus reducing transmission to unvaccinated individuals. PCVs have also been shown to reduce the incidence of antibiotic-resistant pneumococcal disease. Surveillance for pneumococcal disease is important to understand local epidemiology, serotype distribution and antibiotic resistance rates. Surveillance systems also help to inform policy development, including vaccine recommendations, and monitor the impact of pneumococcal vaccination. National pneumococcal surveillance systems exist in a number of countries in Central and Eastern Europe (such as Croatia, Czech Republic, Hungary, Poland, Romania and Slovakia), and some have introduced PCVs (Czech Republic, Hungary, Kazakhstan, Russia, Slovakia and Turkey). Those countries without established programs (such as Kazakhstan, Russia and Ukraine) may be able to learn from the experiences of those with national surveillance systems. The serotype distributions and impact of PCV13 on pediatric pneumococcal diseases are relatively similar in different parts of the world, suggesting that approaches to vaccination used elsewhere are also likely to be effective in Central and Eastern Europe. This article briefly reviews the epidemiology of pneumococcal disease, presents the latest surveillance data from Central and Eastern Europe, and discusses any similarities and differences in these data as well the potential implications for vaccination policies in the region.

Surveillance of pneumococcal diseases in Central and Eastern Europe

PubMed Central

Ceyhan, Mehmet; Dagan, Ron; Sayiner, Abdullah; Chernyshova, Liudmyla; Dinleyici, Ener Çağrı; Hryniewicz, Waleria; Kulcsár, Andrea; Mad'arová, Lucia; Pazdiora, Petr; Sidorenko, Sergey; Streinu-Cercel, Anca; Tambić-Andrašević, Arjana; Yeraliyeva, Lyazzat

2016-01-01

ABSTRACT Pneumococcal infection is a major cause of morbidity and mortality worldwide. The burden of disease associated with S. pneumoniae is largely preventable through routine vaccination. Pneumococcal conjugate vaccines (e.g. PCV7, PCV13) provide protection from invasive pneumococcal disease as well as non-invasive infection (pneumonia, acute otitis media), and decrease vaccine-type nasopharyngeal colonisation, thus reducing transmission to unvaccinated individuals. PCVs have also been shown to reduce the incidence of antibiotic-resistant pneumococcal disease. Surveillance for pneumococcal disease is important to understand local epidemiology, serotype distribution and antibiotic resistance rates. Surveillance systems also help to inform policy development, including vaccine recommendations, and monitor the impact of pneumococcal vaccination. National pneumococcal surveillance systems exist in a number of countries in Central and Eastern Europe (such as Croatia, Czech Republic, Hungary, Poland, Romania and Slovakia), and some have introduced PCVs (Czech Republic, Hungary, Kazakhstan, Russia, Slovakia and Turkey). Those countries without established programs (such as Kazakhstan, Russia and Ukraine) may be able to learn from the experiences of those with national surveillance systems. The serotype distributions and impact of PCV13 on pediatric pneumococcal diseases are relatively similar in different parts of the world, suggesting that approaches to vaccination used elsewhere are also likely to be effective in Central and Eastern Europe. This article briefly reviews the epidemiology of pneumococcal disease, presents the latest surveillance data from Central and Eastern Europe, and discusses any similarities and differences in these data as well the potential implications for vaccination policies in the region. PMID:27096714

Epidemiological modelling for the assessment of bovine tuberculosis surveillance in the dairy farm network in Emilia-Romagna (Italy).

PubMed

Rossi, Gianluigi; De Leo, Giulio A; Pongolini, Stefano; Natalini, Silvano; Vincenzi, Simone; Bolzoni, Luca

2015-06-01

Assessing the performance of a surveillance system for infectious diseases of domestic animals is a challenging task for health authorities. Therefore, it is important to assess what strategy is the most effective in identifying the onset of an epidemic and in minimizing the number of infected farms. The aim of the present work was to evaluate the performance of the bovine tuberculosis (bTB) surveillance system in the network of dairy farms in the Emilia-Romagna (ER) Region, Italy. A bTB-free Region since 2007, ER implements an integrated surveillance strategy based on three components, namely routine on-farm tuberculin skin-testing performed every 3 years, tuberculin skin-testing of cattle exchanged between farms, and post-mortem inspection at slaughterhouses. We assessed the effectiveness of surveillance by means of a stochastic network model of both within-farm and between-farm bTB dynamics calibrated on data available for ER dairy farms. Epidemic dynamics were simulated for five scenarios: the current ER surveillance system, a no surveillance scenario that we used as the benchmark to characterize epidemic dynamics, three additional scenarios in which one of the surveillance components was removed at a time so as to outline its significance in detecting the infection. For each scenario we ran Monte Carlo simulations of bTB epidemics following the random introduction of an infected individual in the network. System performances were assessed through the comparative analysis of a number of statistics, including the time required for epidemic detection and the total number of infected farms during the epidemic. Our analysis showed that slaughterhouse inspection is the most effective surveillance component in reducing the time for disease detection, while routine surveillance in reducing the number of multi-farms epidemics. On the other hand, testing exchanged cattle improved the performance of the surveillance system only marginally. Copyright © 2015 The Authors

Mapping HIV/STI behavioural surveillance in Europe

PubMed Central

2010-01-01

Background Used in conjunction with biological surveillance, behavioural surveillance provides data allowing for a more precise definition of HIV/STI prevention strategies. In 2008, mapping of behavioural surveillance in EU/EFTA countries was performed on behalf of the European Centre for Disease prevention and Control. Method Nine questionnaires were sent to all 31 member States and EEE/EFTA countries requesting data on the overall behavioural and second generation surveillance system and on surveillance in the general population, youth, men having sex with men (MSM), injecting drug users (IDU), sex workers (SW), migrants, people living with HIV/AIDS (PLWHA), and sexually transmitted infection (STI) clinics patients. Requested data included information on system organisation (e.g. sustainability, funding, institutionalisation), topics covered in surveys and main indicators. Results Twenty-eight of the 31 countries contacted supplied data. Sixteen countries reported an established behavioural surveillance system, and 13 a second generation surveillance system (combination of biological surveillance of HIV/AIDS and STI with behavioural surveillance). There were wide differences as regards the year of survey initiation, number of populations surveyed, data collection methods used, organisation of surveillance and coordination with biological surveillance. The populations most regularly surveyed are the general population, youth, MSM and IDU. SW, patients of STI clinics and PLWHA are surveyed less regularly and in only a small number of countries, and few countries have undertaken behavioural surveys among migrant or ethnic minorities populations. In many cases, the identification of populations with risk behaviour and the selection of populations to be included in a BS system have not been formally conducted, or are incomplete. Topics most frequently covered are similar across countries, although many different indicators are used. In most countries, sustainability

The Need for European Surveillance of CDI.

PubMed

Wiuff, Camilla; Banks, A-Lan; Fitzpatrick, Fidelma; Cottom, Laura

2018-01-01

Since the turn of the millennium, the epidemiology of Clostridium difficile infection (CDI) has continued to challenge. Over the last decade there has been a growing awareness that improvements to surveillance are needed. The increasing rate of CDI and emergence of ribotype 027 precipitated the implementation of mandatory national surveillance of CDI in the UK. Changes in clinical presentation, severity of disease, descriptions of new risk factors and the occurrence of outbreaks all emphasised the importance of early diagnosis and surveillance.However a lack of consensus on case definitions, clinical guidelines and optimal laboratory diagnostics across Europe has lead to the underestimation of CDI and impeded comparison between countries. These inconsistencies have prevented the true burden of disease from being appreciated.Acceptance that a multi-country surveillance programme and optimised diagnostic strategies are required not only to detect and control CDI in Europe, but for a better understanding of the epidemiology, has built the foundations for a more robust, unified surveillance. The concerted efforts of the European Centre for Disease Prevention and Control (ECDC) CDI networks, has lead to the development of an over-arching long-term CDI surveillance strategy for 2014-2020. Fulfilment of the ECDC priorities and targets will no doubt be challenging and will require significant investment however the hope is that both a national and Europe-wide picture of CDI will finally be realised.

Troop education and avian influenza surveillance in military barracks in Ghana, 2011.

PubMed

Odoom, John Kofi; Bel-Nono, Samuel; Rodgers, David; Agbenohevi, Prince G; Dafeamekpor, Courage K; Sowa, Roland M L; Danso, Fenteng; Tettey, Reuben; Suu-Ire, Richard; Bonney, Joseph H K; Asante, Ivy A; Aboagye, James; Abana, Christopher Zaab-Yen; Frimpong, Joseph Asamoah; Kronmann, Karl C; Oyofo, Buhari A; Ampofo, William K

2012-11-08

Influenza A viruses that cause highly pathogenic avian influenza (HPAI) also infect humans. In many developing countries such as Ghana, poultry and humans live in close proximity in both the general and military populations, increasing risk for the spread of HPAI from birds to humans. Respiratory infections such as influenza are especially prone to rapid spread among military populations living in close quarters such as barracks making this a key population for targeted avian influenza surveillance and public health education. Twelve military barracks situated in the coastal, tropical rain forest and northern savannah belts of the country were visited and the troops and their families educated on pandemic avian influenza. Attendants at each site was obtained from the attendance sheet provided for registration. The seminars focused on zoonotic diseases, influenza surveillance, pathogenesis of avian influenza, prevention of emerging infections and biosecurity. To help direct public health policies, a questionnaire was used to collect information on animal populations and handling practices from 102 households in the military barracks. Cloacal and tracheal samples were taken from 680 domestic and domesticated wild birds and analysed for influenza A using molecular methods for virus detection. Of the 1028 participants that took part in the seminars, 668 (65%) showed good knowledge of pandemic avian influenza and the risks associated with its infection. Even though no evidence of the presence of avian influenza (AI) infection was found in the 680 domestic and wild birds sampled, biosecurity in the households surveyed was very poor. Active surveillance revealed that there was no AI circulation in the military barracks in April 2011. Though participants demonstrated good knowledge of pandemic avian influenza, biosecurity practices were minimal. Sustained educational programs are needed to further strengthen avian influenza surveillance and prevention in military barracks.

The role of surveillance cultures in guiding ventilator-associated pneumonia therapy.

PubMed

Luna, Carlos M; Bledel, Ignacio; Raimondi, Alejandro

2014-04-01

Ventilator-associated pneumonia (VAP) is the most frequent cause of death among the nosocomial infections acquired in the ICU. Routine surveillance endotracheal aspirate (ETA) cultures in patients on mechanical ventilation have been proposed to predict the cause of VAP. Our aim is to review the available experience regarding the role of surveillance ETA cultures in guiding VAP antimicrobial therapy. Microorganisms arrive in the lower respiratory tract by aspiration from the oropharynx or gastric reflux, extension from a contiguous infection, air contamination or by hematogenous seeding. Bacterial colonization of the airway leads to the development of VAP and may result from the aspiration of oropharyngeal or gastric secretions. Recent studies have suggested that surveillance cultures could provide a rationale for prescribing appropriate antibiotics, while waiting for culture results, in up to 95% of patients in whom VAP is ultimately diagnosed by bronchoalveolar lavage fluid culture. However, some authors observed that guiding therapy with those routine surveillance cultures leads to unacceptably low coverage of the pathogens producing VAP. This article describes the evidence supporting the use of routine ETA cultures to prescribe appropriate initial empirical therapy compared with the current practice dictated by guidelines.

Enterovirus and Parechovirus Surveillance - United States, 2014-2016.

PubMed

Abedi, Glen R; Watson, John T; Nix, W Allan; Oberste, M Steven; Gerber, Susan I

2018-05-11

Infections caused by enteroviruses (EV) and parechoviruses (PeV), members of the Picornaviridae family, are associated with various clinical manifestations, including hand, foot, and mouth disease; respiratory illness; myocarditis; meningitis; and sepsis; and can result in death. The genus Enterovirus includes four species of enterovirus (A-D) known to infect humans, and the genus Parechovirus includes one species (A) that infects humans. These species are further divided into types, some of which are associated with specific clinical manifestations. During 2014-2016, a total of 2,967 U.S. cases of EV and PeV infections were reported to the National Enterovirus Surveillance System (NESS). The largest number of reports during that time (2,051) occurred in 2014, when a large nationwide outbreak of enterovirus D68 (EV-D68) occurred, accounting for 68% of cases reported to NESS that year (1). Reports to the National Respiratory and Enteric Virus Surveillance System (NREVSS) during 2014-2016 indicated that circulation of EV peaks annually in the summer and early fall. Because the predominant types of EV and PeV circulating from year to year tend to vary, tracking these trends requires consistent and complete reports from laboratories with the capacity to perform typing.

INFECTION CONTROL IN ALTERNATIVE HEALTHCARE SETTINGS

PubMed Central

Flanagan, Elaine; Chopra, Teena; Mody, Lona

2011-01-01

SYNOPSIS With the changing healthcare delivery, patients receive care at various settings including acute care hospitals, skilled nursing facilities, outpatient primary care and specialty clinics, as well as at home, exposing them to pathogens in various settings. Various healthcare settings face unique challenges requiring individualized infection control programs. Infection control programs in skilled nursing facilities should address: surveillance for infections and antimicrobial resistance, outbreak investigation and control plan for epidemics, isolation precautions, hand hygiene, staff education, and employee and resident health programs. Infection control programs in ambulatory clinics should address: Triage and standard – transmission based precautions, cleaning, disinfection and sterilization principles, surveillance in surgical clinics, safe injection practices, and bioterrorism and disaster planning for ambulatory clinics. PMID:21316005

Surveillance for West Nile, Dengue, and Chikungunya Virus Infections, Veneto Region, Italy, 2010

PubMed Central

Barzon, Luisa; Capelli, Gioia; Angheben, Andrea; Pacenti, Monia; Napoletano, Giuseppina; Piovesan, Cinzia; Montarsi, Fabrizio; Martini, Simone; Rigoli, Roberto; Cattelan, Anna M.; Rinaldi, Roberto; Conforto, Mario; Russo, Francesca; Palù, Giorgio; Bisoffi, Zeno

2012-01-01

In 2010, in Veneto Region, Italy, surveillance of summer fevers was conducted to promptly identify autochthonous cases of West Nile fever and increase detection of imported dengue and chikungunya in travelers. Surveillance highlighted the need to modify case definitions, train physicians, and when a case is identified, implement vector control measures PMID:22469230

Description of hospitalized cases of influenza A(H1N1)pdm09 infection on the basis of the national hospitalized-case surveillance, 2009-2010, Japan.

PubMed

Shimada, Tomoe; Sunagawa, Tomimasa; Taniguchi, Kiyosu; Yahata, Yuichiro; Kamiya, Hajime; Yamamoto, Kumi Ueno; Yasui, Yoshinori; Okabe, Nobuhiko

2015-01-01

This study reports the epidemiological characteristics of hospitalized cases of influenza A(H1N1)pdm09 infection analyzed on the basis of surveillance data collected from July 24, 2009, the date on which the hospital-based surveillance of influenza cases was implemented in Japan, to September 5, 2010. During the study period, 13,581 confirmed cases were reported. Among those cases with information regarding the reason for hospitalization, 39% were admitted to hospitals for non-therapeutic purposes such as medical observation and laboratory testing. The overall hospitalization rate was 5.8 cases per 100,000 population when cases hospitalized for non-therapeutic purposes were excluded. While those aged under 20 years accounted for over 85% of hospitalized cases, the largest proportion of fatal cases was observed in those aged over 65 years. The overall case fatality rate for all hospitalized cases was 1.5%. The year-round surveillance for hospitalized influenza-like illness cases was launched in 2011, and it was expected that this surveillance system could add value by monitoring changes in the epidemiological characteristics of hospitalized cases of seasonal influenza.

Public health surveillance and infectious disease detection.

PubMed

Morse, Stephen S

2012-03-01

Emerging infectious diseases, such as HIV/AIDS, SARS, and pandemic influenza, and the anthrax attacks of 2001, have demonstrated that we remain vulnerable to health threats caused by infectious diseases. The importance of strengthening global public health surveillance to provide early warning has been the primary recommendation of expert groups for at least the past 2 decades. However, despite improvements in the past decade, public health surveillance capabilities remain limited and fragmented, with uneven global coverage. Recent initiatives provide hope of addressing this issue, and new technological and conceptual advances could, for the first time, place capability for global surveillance within reach. Such advances include the revised International Health Regulations (IHR 2005) and the use of new data sources and methods to improve global coverage, sensitivity, and timeliness, which show promise for providing capabilities to extend and complement the existing infrastructure. One example is syndromic surveillance, using nontraditional and often automated data sources. Over the past 20 years, other initiatives, including ProMED-mail, GPHIN, and HealthMap, have demonstrated new mechanisms for acquiring surveillance data. In 2009 the U.S. Agency for International Development (USAID) began the Emerging Pandemic Threats (EPT) program, which includes the PREDICT project, to build global capacity for surveillance of novel infections that have pandemic potential (originating in wildlife and at the animal-human interface) and to develop a framework for risk assessment. Improved understanding of factors driving infectious disease emergence and new technological capabilities in modeling, diagnostics and pathogen identification, and communications, such as using the increasing global coverage of cellphones for public health surveillance, can further enhance global surveillance.

CRISPR-Cas type I-A Cascade complex couples viral infection surveillance to host transcriptional regulation in the dependence of Csa3b.

PubMed

He, Fei; Vestergaard, Gisle; Peng, Wenfang; She, Qunxin; Peng, Xu

2017-02-28

CRISPR-Cas (clustered regularly interspaced short palindromic repeats and the associated genes) constitute adaptive immune systems in bacteria and archaea and they provide sequence specific immunity against foreign nucleic acids. CRISPR-Cas systems are activated by viral infection. However, little is known about how CRISPR-Cas systems are activated in response to viral infection or how their expression is controlled in the absence of viral infection. Here, we demonstrate that both the transcriptional regulator Csa3b, and the type I-A interference complex Cascade, are required to transcriptionally repress the interference gene cassette in the archaeon Sulfolobus. Csa3b binds to two palindromic repeat sites in the promoter region of the cassette and facilitates binding of the Cascade to the promoter region. Upon viral infection, loading of Cascade complexes onto crRNA-matching protospacers leads to relief of the transcriptional repression. Our data demonstrate a mechanism coupling CRISPR-Cas surveillance of protospacers to transcriptional regulation of the interference gene cassette thereby allowing a fast response to viral infection. © The Author(s) 2016. Published by Oxford University Press on behalf of Nucleic Acids Research.

Molecular epidemiology of vancomycin-resistant enterococcal bacteraemia: results from the Canadian Nosocomial Infection Surveillance Program, 1999-2009.

PubMed

McCracken, M; Wong, A; Mitchell, R; Gravel, D; Conly, J; Embil, J; Johnston, L; Matlow, A; Ormiston, D; Simor, A E; Smith, S; Du, T; Hizon, R; Mulvey, M R

2013-07-01

Vancomycin-resistant enterococci (VRE) can be associated with serious bacteraemia. The focus of this study was to characterize the molecular epidemiology of VRE from bacteraemia cases that were isolated from 1999 to 2009 as part of Canadian Nosocomial Infection Surveillance Program (CNISP) surveillance activities. From 1999 to 2009, enterococci were collected from across Canada in accordance with the CNISP VRE surveillance protocol. MICs were determined using broth microdilution. PCR was used to identify vanA, B, C, D, E, G and L genes. Genetic relatedness was examined using multilocus sequence typing (MLST). A total of 128 cases of bacteraemia were reported to CNISP from 1999 to 2009. In 2007, a significant increase in bacteraemia rates was observed in western and central Canada. Eighty-one of the 128 bacteraemia isolates were received for further characterization and were identified as Enterococcus faecium. The majority of isolates were from western Canada (60.5%), followed by central (37.0%) and eastern (2.5%) Canada. Susceptibilities were as follows: daptomycin, linezolid, tigecycline and chloramphenicol, 100%; quinupristin/dalfopristin, 96.3%; high-level gentamicin, 71.6%; tetracycline, 50.6%; high-level streptomycin, 44.4%; rifampicin, 21.0%; nitrofurantoin, 11.1%; clindamycin, 8.6%; ciprofloxacin, levofloxacin and moxifloxacin, 1.2%; and ampicillin, 0.0%. vanA contributed to vancomycin resistance in 90.1% of isolates and vanB in 9.9%. A total of 17 sequence types (STs) were observed. Beginning in 2006 there was a shift in ST from ST16, ST17, ST154 and ST80 to ST18, ST412, ST203 and ST584. The increase in bacteraemia observed since 2007 in western and central Canada appears to coincide with the shift of MLST STs. All VRE isolates remained susceptible to daptomycin, linezolid, chloramphenicol and tigecycline.

Multi-drug resistance and reduced susceptibility to ciprofloxacin among Salmonella enterica serovar Typhi isolates from the Middle East and Central Asia.

PubMed

Rahman, B A; Wasfy, M O; Maksoud, M A; Hanna, N; Dueger, E; House, B

2014-07-01

Typhoid fever is common in developing countries, with an estimated 120 million infections and 700 000 annual deaths, worldwide. Fluoroquinolones have been the treatment of choice for infection with multidrug-resistant (MDR) Salmonella enterica serovar Typhi (S. Typhi). However, alarming reports of fluoroquinolone-resistance and failure of typhoid fever treatment have recently been published. To determine the proportion of S. Typhi isolates with reduced susceptibility to ciprofloxacin (RSC) from six countries in the Middle East and Central Asia, 968 S. Typhi isolates collected between 2002 and 2007 from Egypt, Uzbekistan, Pakistan, Qatar, Jordan and Iraq were tested for antibiotic susceptibility to five antibiotics using the disc-diffusion method. MDR was defined as resistance to amicillin, chloramphenicol and trimethoprim-sulfamethoxazole. The E-test was employed to determine the MIC of ciprofloxacin only. Nalidixic acid resistance was evaluated as a marker for RSC. Interpretations were made according to CLSI guidelines. MDR strains were considerably more prevalent in Iraq (83%) and Pakistan (52%) compared with the other countries studied (13-52%). Nearly all isolates were susceptible (99.7%) to ceftriaxone. RSC was detected in a total of 218 isolates (22%), mostly from Iraq (54/59, 92%), Uzbekistan (98/123, 80%), Qatar (23/43, 54%) and Pakistan (31/65, 47%). Many of these (21%) were also MDR. Use of nalidixic acid resistance as an indicator for RSC was 99% sensitive and 98% specific. This study reinforces the need for routine antimicrobial susceptibility surveillance of enteric fever isolates and close review of current therapeutic policies in the region.

Real-time automatic hospital-wide surveillance of nosocomial infections and outbreaks in a large Chinese tertiary hospital

PubMed Central

2014-01-01

Background We aimed to develop a real-time nosocomial infection surveillance system (RT-NISS) to monitor all nosocomial infections (NIs) and outbreaks in a Chinese comprehensive hospital to better prevent and control NIs. Methods The screening algorithm used in RT-NISS included microbiological reports, antibiotic usage, serological and molecular testing, imaging reports, and fever history. The system could, in real-time, identify new NIs, record data, and produce time-series reports to align NI cases. Results Compared with a manual survey of NIs (the gold standard), the sensitivity and specificity of RT-NISS was 98.8% (84/85) and 93.0% (827/889), with time-saving efficiencies of about 200 times. RT-NISS obtained the highest hospital-wide monthly NI rate of 2.62%, while physician and medical record reviews reported rates of 1.52% and 2.35% respectively. It took about two hours for one infection control practitioner (ICP) to deal with 70 new suspicious NI cases; there were 3,500 inpatients each day in the study hospital. The system could also provide various updated data (i.e. the daily NI rate, surgical site infection (SSI) rate) for each ward, or the entire hospital. Within 3 years of implementing RT-NISS, the ICPs monitored and successfully controlled about 30 NI clusters and 4 outbreaks at the study hospital. Conclusions Just like the “ICPs’ eyes”, RT-NISS was an essential and efficient tool for the day-to-day monitoring of all NIs and outbreak within the hospital; a task that would not have been accomplished through manual process. PMID:24475790

Surveillance versus clinical adjudication: differences persist with new ventilator-associated event definition.

PubMed

McMullen, Kathleen M; Boyer, Anthony F; Schoenberg, Noah; Babcock, Hilary M; Micek, Scott T; Kollef, Marin H

2015-06-01

The National Healthcare Safety Network (NHSN) has recently supported efforts to shift surveillance away from ventilator-associated pneumonia to ventilator-associated events (VAEs) to decrease subjectivity in surveillance and minimize concerns over clinical correlation. The goals of this study were to compare the results of an automated surveillance strategy using the new VAE definition with a prospectively performed clinical application of the definition. All patients ventilated for ≥2 days in a medical and surgical intensive care unit were evaluated by 2 methods: retrospective surveillance using an automated algorithm combined with manual chart review after the NHSN's VAE methodology and prospective surveillance by pulmonary physicians in collaboration with the clinical team administering care to the patient at the bedside. Overall, a similar number of events were called by each method (69 vs 67). Of the 1,209 patients, 56 were determined to have VAEs by both methods (κ = .81, P = .04). There were 24 patients considered to be a VAE by only 1 of the methods. Most discrepancies were the result of clinical disagreement with the NHSN's VAE methodology. There was good agreement between the study teams. Awareness of the limitations of the surveillance definition for VAE can help infection prevention personnel in discussions with critical care partners about optimal use of these data. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Feasibility of a Mobile Phone-Based Surveillance for Surgical Site Infections in Rural India.

PubMed

Pathak, Ashish; Sharma, Shailendra; Sharma, Megha; Mahadik, Vijay K; Lundborg, Cecilia Stålsby

2015-11-01

To assess the feasibility of using mobile communication technology in completing a 30-day follow-up of surgical site infection (SSI). SSIs are infections occurring up to 30 days after an operative procedure. This prospective exploratory study was conducted in a cohort of patients who were admitted and operated on in the general surgery wards of a rural hospital in India from October 2010 to June 2011. At the time of discharge, all patients were requested to follow-up in the surgical outpatient clinic at 30 days after surgery. If this was not done, a mobile phone-based surveillance was done to complete the follow-up. The mean age of the 536 operated-on patients was 40 years (95% confidence interval [CI], 38-41 years). The mean duration of hospital stay was 10.7 days (95% CI, 9.9-11.6 days). Most (81%) operated-on patients were from rural areas, and 397 (75%) were male. Among the operated-on patients the ownership of mobile phones was 75% (95% CI, 73-78%). The remaining 25% of patients (n=133) used a shared mobile phone. For 380 patients (74.5%) the follow-up was completed by mobile phones. The SSI rate at follow-up was 6.3% (n=34). In 10 patients, an SSI was detected over the mobile phone. Mobile communication technology is feasible to be used in rural settings to complete case follow-up for SSIs.

Prevalence of Asymptomatic Poliovirus Infection in Older Children and Adults in Northern India: Analysis of Contact and Enhanced Community Surveillance, 2009

PubMed Central

Mach, Ondrej; Verma, Harish; Khandait, Devendra W.; Sutter, Roland W.; O'Connor, Patrick M.; Pallansch, Mark A.; Cochi, Stephen L.; Linkins, Robert W.; Chu, Susan Y.; Wolff, Chris; Jafari, Hamid S.

2015-01-01

Background In 2009, enhanced poliovirus surveillance was established in polio-endemic areas of Uttar Pradesh and Bihar, India, to assess poliovirus infection in older individuals. Methods In Uttar Pradesh, stool specimens from asymptomatic household and neighborhood contacts of patients with laboratory-confirmed polio were tested for polioviruses. In Bihar, in community-based surveillance, children and adults from 250 randomly selected households in the Kosi River area provided stool and pharyngeal swab samples that were tested for polioviruses. A descriptive analysis of surveillance data was performed. Results In Uttar Pradesh, 89 of 1842 healthy contacts of case patients with polio (4.8%) were shedding wild poliovirus (WPV); 54 of 85 (63.5%) were ≥5 years of age. Shedding was significantly higher in index households than in neighborhood households (P < .05). In Bihar, 11 of 451 healthy persons (2.4%) were shedding WPV in their stool; 6 of 11 (54.5%) were ≥5 years of age. Mean viral titer was similar in older and younger children. Conclusions A high proportion of persons ≥5 years of age were asymptomatically shedding polioviruses. These findings provide indirect evidence that older individuals could have contributed to community transmission of WPV in India. Polio vaccination campaigns generally target children <5 years of age. Expanding this target age group in polio-endemic areas could accelerate polio eradication. PMID:25316843

Characterizing Lyme Disease Surveillance in an Endemic State.

PubMed

Rutz, H J; Wee, S B; Feldman, K A

2018-03-01

Lyme disease (LD) is the most common vector-borne disease in Maryland and the United States. Surveillance for LD is valuable for understanding the burden of the disease, particularly to assess whether the disease is spreading and to appreciate who is affected. However, not all cases of LD in Maryland are reported, and surveillance practices vary across each of Maryland's 24 local health departments (LHDs). To better understand this variability and to systematically characterize the surveillance process, we surveyed Maryland's LHDs regarding LD surveillance. The Maryland Local Health Department Lyme Disease Surveillance Survey has been administered annually since 2011. Questions asked each year included whether all LD reports are investigated or only a subset, and how many reports are not entered into the surveillance database. Since 2011, Maryland has lost surveillance personnel for LD. Each year from 2009 to 2012, a median 3598 (range 2462 to 5722) reports were not entered into the surveillance database and hence not investigated. These reports represent 43-55% of all reports received for the year. Over time, more LHDs chose to streamline their LD investigation approach by investigating only those reports that met the criteria for laboratory evidence of infection: in 2008, 5 (21%) LHDs investigated only a subset of LD reports; by 2013, this increased to 15 (63%). There is wide variability across LHDs in how LD investigations are conducted. Maryland LHDs have experienced a loss of LD surveillance personnel with a concomitant increase in the number of LHDs adopting a streamlined approach to investigating cases. These findings underscore the tremendous burden of LD on the public health agencies and highlight the need for alternative approaches that can both reduce burden and preserve surveillance data quality. © 2016 Blackwell Verlag GmbH.

HIV surveillance in MENA: recent developments and results.

PubMed

Bozicevic, Ivana; Riedner, Gabriele; Calleja, Jesus Maria Garcia

2013-11-01

To provide an overview of the current level of development and results from the national HIV surveillance systems of the 23 countries of the Middle East and North Africa (MENA), and to assess the quality of HIV surveillance systems in the period 2007-2011. A questionnaire was used to collect the information about the structure, activities and the results of HIV surveillance systems from the National AIDS Programmes. Assessment of the quality was based on four indicators: timeliness of data collection, appropriateness of populations under surveillance, consistency of the surveillance sites and groups measured over time, and coverage of the surveillance system. Only in four countries did surveillance systems enable assessment of epidemic trends in the same populations and locations over time, such as in pregnant women (Morocco, Iran), injecting drug users (Iran, Pakistan), female sex workers (Djibouti, Morocco) and male sex workers (Pakistan). There is increasing evidence of HIV infection being firmly established in at least one of the populations most at risk of HIV in nine MENA countries, while lower risk populations show elevated HIV prevalence in South Sudan, Djibouti and some parts of Somalia. The performance of HIV surveillance systems in several of the MENA countries has improved in recent years. The extent of HIV epidemics in the populations most at risk of HIV is still largely unknown in 10 countries. Multiple data sources that most of the countries still lack would enable indirectly estimation not only of the patterns of HIV epidemics but also the effectiveness of HIV responses.

HIV surveillance in MENA: recent developments and results

PubMed Central

Bozicevic, Ivana; Riedner, Gabriele; Calleja, Jesus Maria Garcia

2013-01-01

Objectives To provide an overview of the current level of development and results from the national HIV surveillance systems of the 23 countries of the Middle East and North Africa (MENA), and to assess the quality of HIV surveillance systems in the period 2007–2011. Methods A questionnaire was used to collect the information about the structure, activities and the results of HIV surveillance systems from the National AIDS Programmes. Assessment of the quality was based on four indicators: timeliness of data collection, appropriateness of populations under surveillance, consistency of the surveillance sites and groups measured over time, and coverage of the surveillance system. Results Only in four countries did surveillance systems enable assessment of epidemic trends in the same populations and locations over time, such as in pregnant women (Morocco, Iran), injecting drug users (Iran, Pakistan), female sex workers (Djibouti, Morocco) and male sex workers (Pakistan). There is increasing evidence of HIV infection being firmly established in at least one of the populations most at risk of HIV in nine MENA countries, while lower risk populations show elevated HIV prevalence in South Sudan, Djibouti and some parts of Somalia. Conclusions The performance of HIV surveillance systems in several of the MENA countries has improved in recent years. The extent of HIV epidemics in the populations most at risk of HIV is still largely unknown in 10 countries. Multiple data sources that most of the countries still lack would enable indirectly estimation not only of the patterns of HIV epidemics but also the effectiveness of HIV responses. PMID:23434789

Effects of viral respiratory disease education and surveillance on antibiotic prescribing.

PubMed

Temte, J L; Shult, P A; Kirk, C J; Amspaugh, J

1999-02-01

We describe a partnership between family practice residency clinics and a state public health virology laboratory that has produced comprehensive viral respiratory disease education and surveillance. Family practice residents have been provided with education on respiratory viruses and the results of ongoing viral surveillance. The preliminary effects of this program on antibiotic prescribing by senior residents are evaluated in this paper. We used a questionnaire to assess the acceptance by family practice residents of the educational component and the utility of ongoing viral surveillance. We used chart review to evaluate rates of antibiotic prescribing and the number of patients diagnosed per year with acute upper respiratory infection and acute bronchitis by senior residents in 1992 (preexposure) and 1996 (postexposure). By the third year of training, most residents (79%) reported receiving adequate training regarding common viral respiratory diseases. Moreover, residents reported that they were less likely to prescribe antibiotics to patients presenting with respiratory infections when provided with specific information on circulating viral pathogens. Antibiotic prescribing in the postexposure group was 68% lower for upper respiratory infection (URI) and 45% lower for a composite of URI and bronchitis. Education and monitoring of circulating respiratory viruses can result in familiarity with common disorders in primary care and reduce unnecessary antibiotic use.

Trichinellosis surveillance--United States, 2008-2012.

PubMed

Wilson, Nana O; Hall, Rebecca L; Montgomery, Susan P; Jones, Jeffrey L

2015-01-16

Trichinellosis is a parasitic disease caused by nematodes in the genus Trichinella, which are among the most widespread zoonotic pathogens globally. Infection occurs following consumption of raw or undercooked meat infected with Trichinella larvae. Clinical manifestations of the disease range from asymptomatic infection to fatal disease; the common signs and symptoms include eosinophilia, fever, periorbital edema, and myalgia. Trichinellosis surveillance has documented a steady decline in the reported incidence of the disease in the United States. In recent years, proportionally fewer cases have been associated with consumption of commercial pork products, and more are associated with meat from wild game such as bear. 2008-2012. Trichinellosis has been a nationally notifiable disease in the United States since 1966 and is reportable in 48 states, New York City, and the District of Columbia. The purpose of national surveillance is to estimate incidence of infection, detect outbreaks, and guide prevention efforts. Cases are defined by clinical characteristics and the results of laboratory testing for evidence of Trichinella infection. Food exposure histories are obtained at the local level either at the point of care or through health department interview. States notify CDC of cases electronically through the National Notifiable Disease Surveillance System (available at http://wwwn.cdc.gov/nndss). In addition, states are asked to submit a standardized supplementary case report form that captures the clinical and epidemiologic information needed to meet the surveillance case definition. Reported cases are summarized weekly and annually in MMWR. During 2008-2012, a total of 90 cases of trichinellosis were reported to CDC from 24 states and the District of Columbia. Six (7%) cases were excluded from analysis because a supplementary case report form was not submitted or the case did not meet the case definition. A total of 84 confirmed trichinellosis cases, including

Nation-wide surveillance of human acute respiratory virus infections between 2013 and 2015 in Korea.

PubMed

Kim, Jeong-Min; Jung, Hee-Dong; Cheong, Hyang-Min; Lee, Anna; Lee, Nam-Joo; Chu, Hyuk; Lee, Joo-Yeon; Kim, Sung Soon; Choi, Jang-Hoon

2018-07-01

The prevalence of eight respiratory viruses detected in patients with acute respiratory infections (ARIs) in Korea was investigated through analysis of data recorded by the Korea Influenza and Respiratory Viruses Surveillance System (KINRESS) from 2013 to 2015. Nasal aspirate and throat swabs specimens were collected from 36 915 patients with ARIs, and viral nucleic acids were detected by real-time (reverse-transcription) polymerase chain reaction for eight respiratory viruses, including human respiratory syncytial viruses (HRSVs), influenza viruses (IFVs), human parainfluenza viruses (HPIVs), human coronaviruses (HCoVs), human rhinovirus (HRV), human adenovirus (HAdV), human bocavirus (HBoV), and human metapneumovirus (HMPV). The overall positive rate of patient specimens was 49.4% (18 236/36 915), 5% of which carried two or more viruses simultaneously. HRV (15.6%) was the most predominantly detected virus, followed by IFVs (14.6%), HAdV (7.5%), HPIVs (5.8%), HCoVs (4.2%), HRSVs (3.6%), HBoV (1.9%), and HMPV (1.6%). Most of the ARIs were significantly correlated with clinical symptoms of fever, cough, and runny nose. Although HRV and HAdV were frequently detected throughout the year in patients, other respiratory viruses showed apparent seasonality. HRSVs and IFVs were the major causative agents of acute respiratory diseases in infants and young children. Overall, this study demonstrates a meaningful relationship between viral infection and typical manifestations of known clinical features as well as seasonality, age distribution, and co-infection among respiratory viruses. Therefore, these data could provide useful information for public health management and to enhance patient care for primary clinicians. © 2018 Wiley Periodicals, Inc.

Methodology and results of integrated WNV surveillance programmes in Serbia

PubMed Central

Šekler, Milanko; Petrić, Dušan; Lazić, Sava; Debeljak, Zoran; Vidanović, Dejan; Ignjatović Ćupina, Aleksandra; Lazić, Gospava; Lupulović, Diana; Kolarević, Mišo; Plavšić, Budimir

2018-01-01

Studies conducted during the past few years have confirmed active West Nile virus (WNV) circulation in Serbia. Based on these studies and the epidemiological situation, the Veterinary Directorate of the Ministry of Agriculture and Environmental Protection launched national WNV surveillance programmes in 2014 and 2015. The programmes encompassed the territory of Serbia and were conducted by the veterinary service in collaboration with entomologists and ornithologists. The objective of the programmes was early detection of WNV and timely reporting to the public health service and local authorities to increase both clinical and mosquito control preparedness. The WNV surveillance programmes were based on direct and indirect surveillance of the presence of WNV by the serological testing of initially seronegative sentinel horses and chickens as well as through viral detection in pooled mosquito and wild bird samples. The most intense WNV circulation was observed in all seven districts of Vojvodina Province (northern Serbia) and Belgrade City, where most of the positive samples were detected among sentinel animals, mosquitoes and wild birds. The West Nile virus surveillance programmes in 2014 and 2015 showed satisfactory results in their capacity to indicate the spatial distribution of the risk for humans and their sensitivity to early detect viral circulation at the enzootic level. Most of the human cases were preceded by the detection of WNV circulation as part of the surveillance programmes. According to the existing data, it can be reasonably assumed that WNV infection, now an endemic infection in Serbia, will continue to present a significant problem for the veterinary service and public health. PMID:29624622

Infection-related microcephaly after the 2015 and 2016 Zika virus outbreaks in Brazil: a surveillance-based analysis.

PubMed

de Oliveira, Wanderson Kleber; de França, Giovanny Vinícius Araújo; Carmo, Eduardo Hage; Duncan, Bruce Bartholow; de Souza Kuchenbecker, Ricardo; Schmidt, Maria Inês

2017-08-26

On Nov 11, 2015, the Brazilian Ministry of Health declared a Public Health Emergency of National Concern in response to an increased number of microcephaly cases, possibly related to previous Zika virus outbreaks. We describe the course of the dual epidemics of the Zika virus infection during pregnancy and microcephaly in Brazil up to Nov 12, 2016, the first anniversary of this declaration. We used secondary data for Zika virus and microcephaly cases obtained through the Brazilian Ministry of Health's surveillance systems from Jan 1, 2015, to Nov 12, 2016. We deemed possible Zika virus infections during pregnancy as all suspected cases of Zika virus disease and all initially suspected, but later discarded, cases of dengue and chikungunya fever. We defined confirmed infection-related microcephaly in liveborn infants as the presence of a head circumference of at least 2 SDs below the mean for their age and sex, accompanied by diagnostic imaging consistent with an infectious cause, or laboratory, clinical, or epidemiological results positive for Zika virus or STORCH (infectious agents known to cause congenital infection, mainly syphilis, toxoplasmosis, cytomegalovirus, and herpes simplex virus). We excluded cases of congenital anomalies or death without microcephaly. We analyse the spatial clustering of these diseases in Brazil to obtain the kernel density estimation. Two distinct waves of possible Zika virus infection extended across all Brazilian regions in 2015 and 2016. 1 673 272 notified cases were reported, of which 41 473 (2·5%) were in pregnant women. During this period, 1950 cases of infection-related microcephaly were confirmed. Most cases (1373 [70·4%]) occurred in the northeast region after the first wave of Zika virus infection, with peak monthly occurrence estimated at 49·9 cases per 10 000 livebirths. After a major, well documented second wave of Zika virus infection in all regions of Brazil from September, 2015, to September, 2016

Developing a new, national approach to surveillance for ventilator-associated events*.

PubMed

Magill, Shelley S; Klompas, Michael; Balk, Robert; Burns, Suzanne M; Deutschman, Clifford S; Diekema, Daniel; Fridkin, Scott; Greene, Linda; Guh, Alice; Gutterman, David; Hammer, Beth; Henderson, David; Hess, Dean; Hill, Nicholas S; Horan, Teresa; Kollef, Marin; Levy, Mitchell; Septimus, Edward; VanAntwerpen, Carole; Wright, Don; Lipsett, Pamela

2013-11-01

To develop and implement an objective, reliable approach to surveillance for ventilator-associated events in adult patients. The Centers for Disease Control and Prevention (CDC) convened a Ventilator-Associated Pneumonia (VAP) Surveillance Definition Working Group in September 2011. Working Group members included representatives of stakeholder societies and organizations and federal partners. The Working Group finalized a three-tier, adult surveillance definition algorithm for ventilator-associated events. The algorithm uses objective, readily available data elements and can identify a broad range of conditions and complications occurring in mechanically ventilated adult patients, including but not limited to VAP. The first tier definition, ventilator-associated condition (VAC), identifies patients with a period of sustained respiratory deterioration following a sustained period of stability or improvement on the ventilator, defined by changes in the daily minimum fraction of inspired oxygen or positive end-expiratory pressure. The second tier definition, infection-related ventilator-associated complication (IVAC), requires that patients with VAC also have an abnormal temperature or white blood cell count, and be started on a new antimicrobial agent. The third tier definitions, possible and probable VAP, require that patients with IVAC also have laboratory and/or microbiological evidence of respiratory infection. Ventilator-associated events surveillance was implemented in January 2013 in the CDC's National Healthcare Safety Network. Modifications to improve surveillance may be made as additional data become available and users gain experience with the new definitions.

Seroincidence of Human Infections With Nontyphoid Salmonella Compared With Data From Public Health Surveillance and Food Animals in 13 European Countries

PubMed Central

Griffin, Patricia M.; Mølbak, Kåre; Simonsen, Jacob; Jørgensen, Charlotte S.; Krogfelt, Karen A.; Falkenhorst, Gerhard; Ethelberg, Steen; Takkinen, Johanna; Emborg, Hanne-Dorthe

2014-01-01

We developed a model that enabled a back-calculation of the annual salmonellosis seroincidence from measurements of Salmonella antibodies and applied this model to 9677 serum samples collected from populations in 13 European countries. We found a 10-fold difference in the seroincidence, which was lowest in Sweden (0.06 infections per person-year), Finland (0.07), and Denmark (0.08) and highest in Spain (0.61), followed by Poland (0.55). These numbers were not correlated with the reported national incidence of Salmonella infections in humans but were correlated with prevalence data of Salmonella in laying hens (P < .001), broilers (P < .001), and slaughter pigs (P = .03). Seroincidence also correlated with Swedish data on the country-specific risk of travel-associated Salmonella infections (P = .001). Estimates based on seroepidemiological methods are well suited to measure the force of transmission of Salmonella to human populations, in particular relevant for assessments where data include notifications from areas, states or countries with diverse characteristics of the Salmonella surveillance. PMID:25100865

Molecular Characterization of Polio from Environmental Samples: ISSP, The Israeli Sewage Surveillance Protocol.

PubMed

Shulman, Lester M; Manor, Yossi; Hindiyeh, Musa; Sofer, Danit; Mendelson, Ella

2016-01-01

Polioviruses are enteric viruses that cause paralytic poliomyelitis in less than 0.5 % of infections and are asymptomatic in >90 % infections of naïve hosts. Environmental surveillance monitors polio in populations rather than in individuals. When this very low morbidity to infection ratio, drops drastically in highly vaccinated populations, environmental surveillance employing manual or automatic sampling coupled with molecular analysis carried out in well-equipped central laboratories becomes the surveillance method of choice since polioviruses are excreted by infected individuals regardless of whether or not the infection is symptomatic. This chapter describes a high throughput rapid turn-around time method for molecular characterization of polioviruses from sewage. It is presented in five modules: (1) Sewage collection and concentration of the viruses in the sewage; (2) Cell cultures for identification of virus in the concentrated sewage; (3) Nucleic acid extractions directly from sewage and from tissue cultures infected with aliquots of concentrated sewage; (4) Nucleic Acid Amplification for poliovirus serotype identification and intratypic differentiation (discriminating wild and vaccine derived polioviruses form vaccine strains); and (5) Molecular characterization of viral RNA by qRT-PCR, TR-PCR, and Sequence analysis. Monitoring silent or symptomatic transmission of vaccine-derived polioviruses or wild polioviruses is critical for the endgame of poliovirus eradication. We present methods for adapting standard kits and validating the changes for this purpose based on experience gained during the recent introduction and sustained transmission of a wild type 1 poliovirus in Israel in 2013 in a population with an initial IPV vaccine coverage >90 %.

Was the French clinical surveillance system of bovine brucellosis influenced by the occurrence and surveillance of other abortive diseases?

PubMed

Bronner, Anne; Morignat, Eric; Touratier, Anne; Gache, Kristel; Sala, Carole; Calavas, Didier

2015-03-01

The bovine brucellosis clinical surveillance system implemented in France aims to detect early any case of bovine brucellosis, a disease of which the country has been declared free since 2005. It relies on the mandatory notification of every bovine abortion. Following the spread of the Schmallenberg virus (SBV) in France in 2012 and 2013, and the implementation in 2012 of a clinical surveillance programme of Q fever based on abortion notifications in ten pilot départements, our objective was to study whether these two events influenced the brucellosis clinical surveillance system. The proportion of notifying farmers was analyzed over each semester from June 1, 2009 to June 30, 2013 according to the size and production type of herds, SBV status of départements and the implementation of the Q fever surveillance. Our analysis showed a slight increase in the proportion of notifying farmers as départements became infected by SBV, and after the implementation of Q fever surveillance (during the first semester of 2013). These variations might be explained by an increase in abortion occurrence (congenital deformities in newborns, due to SBV) and/or by an increase in farmers' and veterinarians' awareness (due to the spread of SBV and the implementation of the Q fever surveillance). These results highlight the difficulties in interpreting variations in the proportion of notifying farmers as a consequence of an increase in abortion occurrence. As bovine abortion surveillance can play an important role in the early warning for several diseases, there is a need to explore other ways to monitor abortions in cattle, such as syndromic surveillance using the dates of artificial insemination or calving data. Copyright © 2015 Elsevier B.V. All rights reserved.

Mapping of the US Domestic Influenza Virologic Surveillance Landscape.

PubMed

Jester, Barbara; Schwerzmann, Joy; Mustaquim, Desiree; Aden, Tricia; Brammer, Lynnette; Humes, Rosemary; Shult, Pete; Shahangian, Shahram; Gubareva, Larisa; Xu, Xiyan; Miller, Joseph; Jernigan, Daniel

2018-07-17

Influenza virologic surveillance is critical each season for tracking influenza circulation, following trends in antiviral drug resistance, detecting novel influenza infections in humans, and selecting viruses for use in annual seasonal vaccine production. We developed a framework and process map for characterizing the landscape of US influenza virologic surveillance into 5 tiers of influenza testing: outpatient settings (tier 1), inpatient settings and commercial laboratories (tier 2), state public health laboratories (tier 3), National Influenza Reference Center laboratories (tier 4), and Centers for Disease Control and Prevention laboratories (tier 5). During the 2015-16 season, the numbers of influenza tests directly contributing to virologic surveillance were 804,000 in tiers 1 and 2; 78,000 in tier 3; 2,800 in tier 4; and 3,400 in tier 5. With the release of the 2017 US Pandemic Influenza Plan, the proposed framework will support public health officials in modeling, surveillance, and pandemic planning and response.

Epidemiology of norovirus infections among diarrhea outpatients in a diarrhea surveillance system in Shanghai, China: a cross-sectional study.

PubMed

Xue, Ying; Pan, Hao; Hu, Jiayu; Wu, Huanyu; Li, Jian; Xiao, Wenjia; Zhang, Xi; Yuan, Zheng'an; Wu, Fan

2015-04-15

Norovirus is an important cause of gastroenteritis both in children and adults. In China, few studies have been conducted on adult populations. This study aimed to determine the contribution of norovirus to gastroenteritis, characterize the features of norovirus infections, compare them with other pathogens, and test the effectiveness of the surveillance system. A citywide surveillance network on diarrhea patients was established. Samples were collected with intervals from both children and adults among diarrhea outpatients in hospitals and tested for viruses using rRT-PCR and for bacteria in CDCs. Patient information was acquired through interviews and recorded into a dedicated online system. The Pearson χ2 test, multivariate logistic regression models and discriminant models were fitted into its comparisons with the non-norovirus group and other pathogens. Norovirus was detected in 22.91% of sampled diarrhea patients. The seasonal distribution of norovirus infections was different from non-norovirus patients (p<0.001), with a half-year peak. Higher proportions of males (p=0.001, OR=1.303, 95% CI=1.110-1.529), local citizens (p<0.001) and officials/clerks (p=0.001, OR=1.348, 95% CI=1.124-1.618) were affected with norovirus when compared with non-norovirus patients. Diarrhea patients affected with norovirus featured nausea (p<0.001, OR=1.418, 95% CI=1.176-1.709) and vomiting (p<0.001, OR=1.969, 95% CI=1.618-2.398), while fewer manifested fever (p=0.046, OR=0.758, 95% CI=0.577-0.996) and abdominal pain (p=0.018, OR=0.815, 95% CI=0.689-0.965). Children were more vulnerable to rotavirus (p=0.008, OR=1.637, 95% CI=1.136-2.358) and bacteria (p=0.027, OR=1.511, 95% CI=1.053-2.169) than norovirus. There was a seasonal difference between the GI and GII genotypes (p<0.001). Officials or clerks were more easily affected with GI than GII (p=0.006, OR=1.888, 95% CI=1.205-2.958). This study was based on a citywide hospital-sentinel surveillance system with multiple enteric

Findings of the International Nosocomial Infection Control Consortium (INICC), Part I: Effectiveness of a multidimensional infection control approach on catheter-associated urinary tract infection rates in pediatric intensive care units of 6 developing countries.

PubMed

Rosenthal, Victor D; Ramachandran, Bala; Dueñas, Lourdes; Alvarez-Moreno, Carlos; Navoa-Ng, J A; Armas-Ruiz, Alberto; Ersoz, Gulden; Matta-Cortés, Lorena; Pawar, Mandakini; Nevzat-Yalcin, Ata; Rodríguez-Ferrer, Marena; Bran de Casares, Ana Concepción; Linares, Claudia; Villanueva, Victoria D; Campuzano, Roberto; Kaya, Ali; Rendon-Campo, Luis Fernando; Gupta, Amit; Turhan, Ozge; Barahona-Guzmán, Nayide; de Jesús-Machuca, Lilian; Tolentino, María Corazon V; Mena-Brito, Jorge; Kuyucu, Necdet; Astudillo, Yamileth; Saini, Narinder; Gunay, Nurgul; Sarmiento-Villa, Guillermo; Gumus, Eylul; Lagares-Guzmán, Alfredo; Dursun, Oguz

2012-07-01

A before-after prospective surveillance study to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) rates. Pediatric intensive care units (PICUs) of hospital members of the International Nosocomial Infection Control Consortium (INICC) from 10 cities of the following 6 developing countries: Colombia, El Salvador, India, Mexico, Philippines, and Turkey. PICU inpatients. We performed a prospective active surveillance to determine rates of CAUTI among 3,877 patients hospitalized in 10 PICUs for a total of 27,345 bed-days. The study was divided into a baseline period (phase 1) and an intervention period (phase 2). In phase 1, surveillance was performed without the implementation of the multidimensional approach. In phase 2, we implemented a multidimensional infection control approach that included outcome surveillance, process surveillance, feedback on CAUTI rates, feedback on performance, education, and a bundle of preventive measures. The rates of CAUTI obtained in phase 1 were compared with the rates obtained in phase 2, after interventions were implemented. During the study period, we recorded 8,513 urinary catheter (UC) days, including 1,513 UC-days in phase 1 and 7,000 UC-days in phase 2. In phase 1, the CAUTI rate was 5.9 cases per 1,000 UC-days, and in phase 2, after implementing the multidimensional infection control approach for CAUTI prevention, the rate of CAUTI decreased to 2.6 cases per 1,000 UC-days (relative risk, 0.43 [95% confidence interval, 0.21-1.0]), indicating a rate reduction of 57%. Our findings demonstrated that implementing a multidimensional infection control approach is associated with a significant reduction in the CAUTI rate of PICUs in developing countries.

Surveillance on the endemic of Zika virus infection by meteorological factors in Colombia: a population-based spatial and temporal study.

PubMed

Chien, Lung-Chang; Lin, Ro-Ting; Liao, Yunqi; Sy, Francisco S; Pérez, Adriana

2018-04-17

Zika virus (ZIKV) infection is a pandemic and a public health emergency. It is transmitted by mosquitoes, primarily the Aedes genus. In light of no treatment currently, it is crucial to develop effective vector control programs to prevent the spread of ZIKV infection earlier when observing possible risk factors, such as weather conditions enhancing mosquito breeding and surviving. This study collected daily meteorological measurements and weekly ZIKV infectious cases among 32 departments of Colombia from January 2015-December 2016. This study applied the distributed lag nonlinear model to estimate the association between the number of ZIKA virus infection and meteorological measurements, controlling for spatial and temporal variations. We examined at most three meteorological factors with 20 lags in weeks in the model. Average humidity, total rainfall, and maximum temperature were more predictable of ZIKV infection outbreaks than other meteorological factors. Our models can detect significantly lagged effects of average humidity, total rainfall, and maximum temperature on outbreaks up to 15, 14, and 20 weeks, respectively. The spatial analysis identified 12 departments with a significant threat of ZIKV, and eight of those high-risk departments were located between the Equator and 6°N. The outbreak prediction also performed well in identified high-risk departments. Our results demonstrate that meteorological factors could be used for predicting ZIKV epidemics. Building an early warning surveillance system is important for preventing ZIKV infection, particularly in endemic areas.

HIV Surveillance and Epidemic Profile in the Middle East and North Africa

PubMed Central

Shawky, Sherine; Soliman, Cherif; Kassak, Kassem M.; Oraby, Doaa; El-Khoury, Danielle; Kabore, Inoussa

2011-01-01

Summary HIV infection is the most devastating infection that has emerged in the recent history. The risk of being infected can be associated with both individual’s knowledge and behavior and community vulnerability influenced by cultural norms, laws, politics, and social practices. Despite that the countries in the Middle East and North Africa have succeeded in keeping low the HIV epidemic rates, the number of identified infected cases are increasing. Since the appearance of the first AIDS cases, all the national authorities devoted their efforts to abort the epidemic in its early stages. The rate of new HIV infections across the Middle East and North Africa region are not at an alarming level, but the need for a concerted effort from nation-states and nongovernmental organizations to stem the spread of the virus across the region is vital. Most countries of the region have put in place better information systems to track the HIV epidemic, yet the passive HIV/AIDS reporting remains the cornerstone in the HIV surveillance systems. Several countries still believe that their current strategies are optimal to the HIV status within their territories and that their national strategies are appropriate to their low epidemic status that is not expected to grow. Additionally, these countries fear that establishing an HIV national program to survey risk behaviors may be perceived as an approval of these behaviors that are culturally and religiously unacceptable. This background article aims to summarize the HIV surveillance strategies and epidemic profile in 17 Arab countries in the Middle East and North Africa. The article, also, displays the national surveillance system and the epidemic profile in Egypt and Lebanon as models for the region. This information aims to provide useful insights that may help the national authorities in finding out the best surveillance strategies that allow merging and collecting biological and risk data which is an integral part of their

A profile of the online dissemination of national influenza surveillance data.

PubMed

Cheng, Calvin Ky; Lau, Eric Hy; Ip, Dennis Km; Yeung, Alfred Sy; Ho, Lai Ming; Cowling, Benjamin J

2009-09-16

Influenza surveillance systems provide important and timely information to health service providers on trends in the circulation of influenza virus and other upper respiratory tract infections. Online dissemination of surveillance data is useful for risk communication to health care professionals, the media and the general public. We reviewed national influenza surveillance websites from around the world to describe the main features of surveillance data dissemination. We searched for national influenza surveillance websites for every country and reviewed the resulting sites where available during the period from November 2008 through February 2009. Literature about influenza surveillance was searched at MEDLINE for relevant hyperlinks to related websites. Non-English websites were translated into English using human translators or Google language tools. A total of 70 national influenza surveillance websites were identified. The percentage of developing countries with surveillance websites was lower than that of developed countries (22% versus 57% respectively). Most of the websites (74%) were in English or provided an English version. The most common surveillance methods included influenza-like illness consultation rates in primary care settings (89%) and laboratory surveillance (44%). Most websites (70%) provided data within a static report format and 66% of the websites provided data with at least weekly resolution. Appropriate dissemination of surveillance data is important to maximize the utility of collected data. There may be room for improvement in the style and content of the dissemination of influenza data to health care professionals and the general public.

[Surveillance of schistosomiasis epidemic situation after its transmission in- terrupted in Lufeng County, Yunnan Province].

PubMed

Hua, Ming-gui; Jin, Hua-zhong; Liu, Jian-hua; Duan, Hong-mei; Xu, Xin-mini

2015-08-01

To investigate the schistosomiasis epidemic situation changes after its transmission interrupted in Lufeng County in 1986, so as to provide the evidence for formulating the interventions for schistosomiasis elimination. The surveillance of Oncomelania hupensis snail was performed by the systematic sampling, environmental sampling and special environmental comprehensive survey methods. The surveillance of human population was carried out by the sero logical screening method, and the positives were re-examined with the stool hatching method. The surveillance of livestock was performed by the plastic cup of pipe jacking hatching method. The living snails were detected in Lufeng County from 1987 to 2007 except in 1988 and 1994. The two import buffalo infected with schistosomes were detected in 2001 and ni local infected livestock were found. Since 2004, the comprehensive measures, including the social control strategy and surviv al snail elimination, were carried out, and no snails were detected and no schistosome infected persons or livestock were found for 7 consecutive years since 2008. The achievement of schistosomiasis transmission interrupted ha been consolidated in Lufeng County, but most of the historical snail environments have not been modified and there are stil snail breeding conditions. Therefore, we should continue to carry out the snail surveillance.

A new basal hadrosauroid dinosaur from the Late Cretaceous of Uzbekistan and the early radiation of duck-billed dinosaurs.

PubMed

Sues, Hans-Dieter; Averianov, Alexander

2009-07-22

Levnesovia transoxiana gen. et sp. nov., from the Late Cretaceous (Middle-Late Turonian) of Uzbekistan, is the oldest well-documented taxon referable to Hadrosauroidea sensu Godefroit et al. It differs from a somewhat younger and closely related Bactrosaurus from Inner Mongolia (China) by a tall sagittal crest on the parietals and the absence of club-shaped dorsal neural spines in adult specimens. Levnesovia, Bactrosaurus and possibly Gilmoreosaurus represent the earliest radiation of Hadrosauroidea, which took place during the Cenomanian-Turonian and possibly in North America. The second, Santonian-age radiation of Hadrosauroidea included Aralosaurus, Hadrosauridae and lineages leading to Tanius (Campanian) and Telmatosaurus (Maastrichtian). Hadrosauridae appears to be monophyletic, but Hadrosaurinae and Lambeosaurinae originated in North America and Asia, respectively.

Role of congenital rubella reference laboratory: 21-months-surveillance in Liguria, Italy.

PubMed

Canepa, P; Valle, L; Cristina, E; De Florentiis, D; Parodi, V; Banfi, F; Zancolli, M; Durando, P; Icardi, G; Ansaldi, F

2009-12-01

Rubella is generally a mild rush fever disease when acquired in childhood, but when infection occurs during the first months of pregnancy, high risk of trans-placental transmission to the foetus and of congenital anomalies exists. In November 2003, a National Plan for measles and congenital rubella elimination was approved in Italy. The aim was to reduce and maintain Congenital Rubella Syndrome incidence lower than 1 case per 100,000 live births/year by 2007. Since June 2006, Liguria Administrative Region recognized U.O. Hygiene, "San Martino" University Hospital, Genoa, as regional reference laboratory for diagnosis of rubella infection during pregnancy and post-partum. Twenty-one-month virological-surveillance results between April 2007 and December 2008 were reported in terms of demographic data, risk factors, access reasons, clinical picture, vaccination, previous rubella disease, laboratory results of pregnant women and newborns. Since the beginning of surveillance, 65 pregnant women with suspected virus infection and 18 newborns with suspected congenital rubella were followed up. The results of laboratory surveillance highlighted (i) the importance of an early screening, (ii) the suboptimal specificity of chemiluminescent assays, that often yield false positive IgM results and (iii) the fundamental role of second-level laboratory to confirm the serological diagnosis and to detect the virus by molecular techniques.

Developing a new national approach to surveillance for ventilator-associated events: executive summary.

PubMed

Magill, Shelley S; Klompas, Michael; Balk, Robert; Burns, Suzanne M; Deutschman, Clifford S; Diekema, Daniel; Fridkin, Scott; Greene, Linda; Guh, Alice; Gutterman, David; Hammer, Beth; Henderson, David; Hess, Dean R; Hill, Nicholas S; Horan, Teresa; Kollef, Marin; Levy, Mitchell; Septimus, Edward; VanAntwerpen, Carole; Wright, Don; Lipsett, Pamela

2013-11-01

In September 2011, the Centers for Disease Control and Prevention (CDC) convened a Ventilator-Associated Pneumonia (VAP) Surveillance Definition Working Group to organize a formal process for leaders and experts of key stakeholder organizations to discuss the challenges of VAP surveillance definitions and to propose new approaches to VAP surveillance in adult patients (Table 1). The charges to the Working Group were to (1) critically review a draft, streamlined VAP surveillance definition developed for use in adult patients; (2) suggest modifications to enhance the reliability and credibility of the surveillance definition within the critical care and infection prevention communities; and (3) propose a final adult surveillance definition algorithm to be implemented in the CDC's National Healthcare Safety Network (NHSN), taking into consideration the potential future use of the definition algorithm in public reporting, interfacility comparisons, and pay-for-reporting and pay-for-performance programs. Published by Mosby, Inc.

Syndromic surveillance of abortions in beef cattle based on the prospective analysis of spatio-temporal variations of calvings.

PubMed

Bronner, A; Morignat, E; Fournié, G; Vergne, T; Vinard, J-L; Gay, E; Calavas, D

2015-12-21

Our objective was to study the ability of a syndromic surveillance system to identify spatio-temporal clusters of drops in the number of calvings among beef cows during the Bluetongue epizootic of 2007 and 2008, based on calving seasons. France was partitioned into 300 iso-populated units, i.e. units with quite the same number of beef cattle. Only 1% of clusters were unlikely to be related to Bluetongue. Clusters were detected during the calving season of primary infection by Bluetongue in 28% (n = 23) of the units first infected in 2007, and in 87% (n = 184) of the units first infected in 2008. In units in which a first cluster was detected over their calving season of primary infection, Bluetongue was detected more rapidly after the start of the calving season and its prevalence was higher than in other units. We believe that this type of syndromic surveillance system could improve the surveillance of abortive events in French cattle. Besides, our approach should be used to develop syndromic surveillance systems for other diseases and purposes, and in other settings, to avoid "false" alarms due to isolated events and homogenize the ability to detect abnormal variations of indicator amongst iso-populated units.

Syndromic surveillance of abortions in beef cattle based on the prospective analysis of spatio-temporal variations of calvings

PubMed Central

Bronner, A.; Morignat, E.; Fournié, G.; Vergne, T.; Vinard, J-L; Gay, E.; Calavas, D.

2015-01-01

Our objective was to study the ability of a syndromic surveillance system to identify spatio-temporal clusters of drops in the number of calvings among beef cows during the Bluetongue epizootic of 2007 and 2008, based on calving seasons. France was partitioned into 300 iso-populated units, i.e. units with quite the same number of beef cattle. Only 1% of clusters were unlikely to be related to Bluetongue. Clusters were detected during the calving season of primary infection by Bluetongue in 28% (n = 23) of the units first infected in 2007, and in 87% (n = 184) of the units first infected in 2008. In units in which a first cluster was detected over their calving season of primary infection, Bluetongue was detected more rapidly after the start of the calving season and its prevalence was higher than in other units. We believe that this type of syndromic surveillance system could improve the surveillance of abortive events in French cattle. Besides, our approach should be used to develop syndromic surveillance systems for other diseases and purposes, and in other settings, to avoid “false” alarms due to isolated events and homogenize the ability to detect abnormal variations of indicator amongst iso-populated units. PMID:26687099

Viruses associated with acute respiratory infections and influenza-like illness among outpatients from the Influenza Incidence Surveillance Project, 2010-2011.

PubMed

Fowlkes, Ashley; Giorgi, Andrea; Erdman, Dean; Temte, Jon; Goodin, Kate; Di Lonardo, Steve; Sun, Yumei; Martin, Karen; Feist, Michelle; Linz, Rachel; Boulton, Rachelle; Bancroft, Elizabeth; McHugh, Lisa; Lojo, Jose; Filbert, Kimberly; Finelli, Lyn

2014-06-01

The Influenza Incidence Surveillance Project (IISP) monitored outpatient acute respiratory infection (ARI; defined as the presence of ≥ 2 respiratory symptoms not meeting ILI criteria) and influenza-like illness (ILI) to determine the incidence and contribution of associated viral etiologies. From August 2010 through July 2011, 57 outpatient healthcare providers in 12 US sites reported weekly the number of visits for ILI and ARI and collected respiratory specimens on a subset for viral testing. The incidence was estimated using the number of patients in the practice as the denominator, and the virus-specific incidence of clinic visits was extrapolated from the proportion of patients testing positive. The age-adjusted cumulative incidence of outpatient visits for ARI and ILI combined was 95/1000 persons, with a viral etiology identified in 58% of specimens. Most frequently detected were rhinoviruses/enteroviruses (RV/EV) (21%) and influenza viruses (21%); the resulting extrapolated incidence of outpatient visits was 20 and 19/1000 persons respectively. The incidence of influenza virus-associated clinic visits was highest among patients aged 2-17 years, whereas other viruses had varied patterns among age groups. The IISP provides a unique opportunity to estimate the outpatient respiratory illness burden by etiology. Influenza virus infection and RV/EV infection(s) represent a substantial burden of respiratory disease in the US outpatient setting, particularly among children.

Filariasis in Travelers Presenting to the GeoSentinel Surveillance Network

PubMed Central

Lipner, Ettie M.; Law, Melissa A.; Barnett, Elizabeth; Keystone, Jay S.; von Sonnenburg, Frank; Loutan, Louis; Prevots, D. Rebecca; Klion, Amy D.; Nutman, Thomas B.

2007-01-01

Background As international travel increases, there is rising exposure to many pathogens not traditionally encountered in the resource-rich countries of the world. Filarial infections, a great problem throughout the tropics and subtropics, are relatively rare among travelers even to filaria-endemic regions of the world. The GeoSentinel Surveillance Network, a global network of medicine/travel clinics, was established in 1995 to detect morbidity trends among travelers. Principal Findings We examined data from the GeoSentinel database to determine demographic and travel characteristics associated with filaria acquisition and to understand the differences in clinical presentation between nonendemic visitors and those born in filaria-endemic regions of the world. Filarial infections comprised 0.62% (n = 271) of all medical conditions reported to the GeoSentinel Network from travelers; 37% of patients were diagnosed with Onchocerca volvulus, 25% were infected with Loa loa, and another 25% were diagnosed with Wuchereria bancrofti. Most infections were reported from immigrants and from those immigrants returning to their county of origin (those visiting friends and relatives); the majority of filarial infections were acquired in sub-Saharan Africa. Among the patients who were natives of filaria-nonendemic regions, 70.6% acquired their filarial infection with exposure greater than 1 month. Moreover, nonendemic visitors to filaria-endemic regions were more likely to present to GeoSentinel sites with clinically symptomatic conditions compared with those who had lifelong exposure. Significance Codifying the filarial infections presenting to the GeoSentinel Surveillance Network has provided insights into the clinical differences seen among filaria-infected expatriates and those from endemic regions and demonstrated that O. volvulus infection can be acquired with short-term travel. PMID:18160987

Implementing GermWatcher, an enterprise infection control application.

PubMed

Doherty, Joshua; Noirot, Laura A; Mayfield, Jennie; Ramiah, Sridhar; Huang, Christine; Dunagan, Wm Claiborne; Bailey, Thomas C

2006-01-01

Automated surveillance tools can provide significant advantages to infection control practitioners. When stored in a relational database, the data collected can also be used to support numerous research and quality improvement opportunities. A previously described electronic infection control surveillance system was remodeled to provide multi-hospital support, an XML based rule set, and interoperability with an enterprise terminology server. This paper describes the new architecture being used at hospitals across BJC HealthCare.

A Bayesian zero-truncated approach for analysing capture-recapture count data from classical scrapie surveillance in France.

PubMed

Vergne, Timothée; Calavas, Didier; Cazeau, Géraldine; Durand, Benoît; Dufour, Barbara; Grosbois, Vladimir

2012-06-01

Capture-recapture (CR) methods are used to study populations that are monitored with imperfect observation processes. They have recently been applied to the monitoring of animal diseases to evaluate the number of infected units that remain undetected by the surveillance system. This paper proposes three bayesian models to estimate the total number of scrapie-infected holdings in France from CR count data obtained from the French classical scrapie surveillance programme. We fitted two zero-truncated Poisson (ZTP) models (with and without holding size as a covariate) and a zero-truncated negative binomial (ZTNB) model to the 2006 national surveillance count dataset. We detected a large amount of heterogeneity in the count data, making the use of the simple ZTP model inappropriate. However, including holding size as a covariate did not bring any significant improvement over the simple ZTP model. The ZTNB model proved to be the best model, giving an estimation of 535 (CI(95%) 401-796) infected and detectable sheep holdings in 2006, although only 141 were effectively detected, resulting in a holding-level prevalence of 4.4‰ (CI(95%) 3.2-6.3) and a sensitivity of holding-level surveillance of 26% (CI(95%) 18-35). The main limitation of the present study was the small amount of data collected during the surveillance programme. It was therefore not possible to build complex models that would allow depicting more accurately the epidemiological and detection processes that generate the surveillance data. We discuss the perspectives of capture-recapture count models in the context of animal disease surveillance. Copyright © 2012 Elsevier B.V. All rights reserved.

Dengue data and surveillance in Tanzania: a systematic literature review.

PubMed

Ward, Tara; Samuel, Moody; Maoz, Dorit; Runge-Ranzinger, Silvia; Boyce, Ross; Toledo, Joao; Velayudhan, Raman; Horstick, Olaf

2017-08-01

Although there is evidence that dengue virus is circulating in Tanzania, the country lacks a dengue surveillance system. Consequently, the true estimate of dengue seroprevalence, as well as the incidence in the population, the frequency and magnitude of outbreaks is unknown. This study therefore sought to systematically review available dengue data from Tanzania. The systematic review was conducted and reported using the PRISMA tool. Five databases (PubMed, Embase, Web of Science, WHOLIS and Google Scholar) were searched for articles using various keywords on the illness, data and geographical location. Identified articles were assessed for inclusion based on predefined eligibility criteria. Data were extracted from included articles, analysed and reported. Based on the 10 seroprevalence studies in defined populations with estimates of acute confirmed infections that were included in the review, the estimated seroprevalence of past dengue infection in Tanzania ranged from 50.6% in a health facility-based study to 11% in a population-based study. Acute confirmed infections of dengue were estimated to be as high as 38.2% of suspected cases. Only one study reported on an outbreak. It is evident that dengue needs to become part of regular disease surveillance in Tanzania. Control measures need to be instituted with a focus on building human resource capacity and integrating dengue control measures in ongoing health programmes, for both preventive and curative interventions. Systematic reviews are valuable in assessing health issues when surveillance data are not available. © 2017 John Wiley & Sons Ltd.

Use of the International Classification of Diseases, 9th revision, coding in identifying chronic hepatitis B virus infection in health system data: implications for national surveillance.

PubMed

Mahajan, Reena; Moorman, Anne C; Liu, Stephen J; Rupp, Loralee; Klevens, R Monina

2013-05-01

With increasing use electronic health records (EHR) in the USA, we looked at the predictive values of the International Classification of Diseases, 9th revision (ICD-9) coding system for surveillance of chronic hepatitis B virus (HBV) infection. The chronic HBV cohort from the Chronic Hepatitis Cohort Study was created based on electronic health records (EHR) of adult patients who accessed services from 2006 to 2008 from four healthcare systems in the USA. Using the gold standard of abstractor review to confirm HBV cases, we calculated the sensitivity, specificity, positive and negative predictive values using one qualifying ICD-9 code versus using two qualifying ICD-9 codes separated by 6 months or greater. Of 1 652 055 adult patients, 2202 (0.1%) were confirmed as having chronic HBV. Use of one ICD-9 code had a sensitivity of 83.9%, positive predictive value of 61.0%, and specificity and negative predictive values greater than 99%. Use of two hepatitis B-specific ICD-9 codes resulted in a sensitivity of 58.4% and a positive predictive value of 89.9%. Use of one or two hepatitis B ICD-9 codes can identify cases with chronic HBV infection with varying sensitivity and positive predictive values. As the USA increases the use of EHR, surveillance using ICD-9 codes may be reliable to determine the burden of chronic HBV infection and would be useful to improve reporting by state and local health departments.

Estimation of the sensitivity of the surveillance system for avian influenza in the western region of Cuba.

PubMed

Ferrer, Edyniesky; Calistri, Paolo; Fonseca, Osvaldo; Ippoliti, Carla; Alfonso, Pastor; Iannetti, Simona; Abeledo, María A; Fernández, Octavio; Percedo, María I; Pérez, Antonio

2013-01-01

Although avian influenza (AI) virus of H5 and H7 subtypes has the potential to mutate to a highly pathogenic form and cause very high mortalities in some poultry species, most AI infections in poultry are due to low pathogenic AI (LPAI). Hence serological surveys, coupled with passive surveillance activities, are essential to detect sub-clinical infections by LPAI viruses, H5 and H7 subtypes. However the proper planning of an active surveillance system should be based on a careful estimation of its performance. Therefore, the sensitivity of the active surveillance system for AI in the western region of Cuba was assessed by a stochastic model quantifying the probability of revealing at least one animal infected by H5 or H7 subtype. The diagnostic sensitivity of the haemagglutination inhibition assay and different levels of within-flock prevalence (5%, 12% and 30%) were considered. The sensitivity of the surveillance system was then assessed under five different samples size scenarios: testing 20, 30, 40, 50 or 60 animals in each flock. Poultry flock sites in the western region of Cuba with a size ranging from 10,000 to 335,000 birds were included in the study.

Landslide Hazard Assessment In Mountaneous Area of Uzbekistan

NASA Astrophysics Data System (ADS)

Nyazov, R. A.; Nurtaev, B. S.

Because of the growth of population and caretaking of the flat areas under agricul- ture, mountain areas have been intensively mastered, producing increase of natural and technogenic processes in Uzbekistan last years. The landslides are the most dan- gerous phenomena and 7240 of them happened during last 40 years. More than 50 % has taken place in the term of 1991 - 2000 years. The situation is aggravated be- cause these regions are situated in zones, where disastrous earthquakes with M> 7 occurred in past and are expected in the future. Continuing seismic gap in Uzbek- istan during last 15-20 years and last disastrous earthquakes occurred in Afghanistan, Iran, Turkey, Greece, Taiwan and India worry us. On the basis of long-term observa- tions the criteria of landslide hazard assessment (suddenness, displacement interval, straight-line directivity, kind of residential buildings destruction) are proposed. This methodology was developed on two geographic levels: local (town scale) and regional (region scale). Detailed risk analysis performed on a local scale and extrapolated to the regional scale. Engineering-geologic parameters content of hazard estimation of landslides and mud flows also is divided into regional and local levels. Four degrees of danger of sliding processes are distinguished for compiling of small-scale, medium- and large-scale maps. Angren industrial area in Tien-Shan mountain is characterized by initial seismic intensity of 8-9 (MSC scale). Here the human technological activity (open-cast mining) has initiated the forming of the large landslide that covers more- over 8 square kilometers and corresponds to a volume of 800 billion cubic meters. In turn the landslide influence can become the source of industrial emergencies. On an example of Angren industrial mining region, the different scenarios on safety control of residing of the people and motion of transport, regulating technologies definition of field improvement and exploitation of mountain

Impact of a multidimensional infection control approach on catheter-associated urinary tract infection rates in an adult intensive care unit in Lebanon: International Nosocomial Infection Control Consortium (INICC) findings.

PubMed

Kanj, Souha S; Zahreddine, Nada; Rosenthal, Victor Daniel; Alamuddin, Lamia; Kanafani, Zeina; Molaeb, Bassel

2013-09-01

The objective of this study was to assess the impact of a multidimensional infection control approach for the reduction of catheter-associated urinary tract infection (CAUTI) in an adult intensive care unit (ICU) of a hospital member of the International Nosocomial Infection Control Consortium (INICC) in Lebanon. A before-after prospective active surveillance study was carried out to determine rates of CAUTI in 1506 ICU patients, hospitalized during 10 291 bed-days. The study period was divided into two phases: phase 1 (baseline) and phase 2 (intervention). During phase 1, surveillance was performed applying the definitions of the US Centers for Disease Control and Prevention National Healthcare Safety Network (CDC/NHSN). In phase 2, we adopted a multidimensional approach that included: (1) a bundle of infection control interventions, (2) education, (3) surveillance of CAUTI rates, (4) feedback on CAUTI rates, (5) process surveillance, and (6) performance feedback. We used random effects Poisson regression to account for clustering of CAUTI rates across time-periods. We recorded a total of 9829 urinary catheter-days: 306 in phase 1 and 9523 in phase 2. The rate of CAUTI was 13.07 per 1000 urinary catheter-days in phase 1, and was decreased by 83% in phase 2 to 2.21 per 1000 urinary catheter-days (risk ratio 0.17; 95% confidence interval 0.06-0.5; p=0.0002). Our multidimensional approach was associated with a significant reduction in the CAUTI rate. Copyright © 2013. Published by Elsevier Ltd.

Viral Infection in Adults with Severe Acute Respiratory Infection in Colombia

PubMed Central

Remolina, Yuly Andrea; Ulloa, María Mercedes; Vargas, Hernán; Díaz, Liliana; Gómez, Sandra Liliana; Saavedra, Alfredo; Sánchez, Edgar; Cortés, Jorge Alberto

2015-01-01

Objectives To identify the viral aetiology in adult patients with severe acute respiratory infection (SARI) admitted to sentinel surveillance institutions in Bogotá in 2012. Design A cross-sectional study was conducted in which microarray molecular techniques for viral identification were used on nasopharyngeal samples of adult patients submitted to the surveillance system, and further descriptions of clinical features and relevant clinical outcomes, such as mortality, need for critical care, use of mechanical ventilation and hospital stay, were obtained. Setting Respiratory infections requiring hospital admission in surveillance centres in Bogotá, Colombia. Participants Ninety-one adult patients with acute respiratory infection (55% were female). Measurements Viral identification, intensive care unit admission, hospital stay, and mortality. Results Viral identification was achieved for 63 patients (69.2%). Comorbidity was frequently identified and mainly involved chronic pulmonary disease or pregnancy. Influenza, Bocavirus and Adenovirus were identified in 30.8%, 28.6% and 18.7% of the cases, respectively. Admission to the intensive care unit occurred in 42.9% of the cases, while mechanical ventilation was required for 36.3%. The average hospital stay was 9.9 days, and mortality was 15.4%. Antibiotics were empirically used in 90.1% of patients. Conclusions The prevalence of viral aetiology of SARI in this study was high, with adverse clinical outcomes, intensive care requirements and high mortality. PMID:26576054

The added value of a water footprint approach: Micro- and macroeconomic analysis of cotton production, processing and export in water bound Uzbekistan

NASA Astrophysics Data System (ADS)

Rudenko, I.; Bekchanov, M.; Djanibekov, U.; Lamers, J. P. A.

2013-11-01

Since independence from the former Soviet Union in 1991, Uzbekistan is challenged to consolidate its efforts and identify and introduce suitable agricultural policies to ease the threat of advancing land, water and ecosystem deterioration. On the one hand, irrigated cotton production provides income, food and energy sources for a large part of the rural households, which accounts for about 70% of the total population. On the other hand, this sector is considered a major driver of the on-going environmental degradation. Due to this dual nature, an integrated approach is needed that allows the analyses of the cotton sector at different stages and, consequently, deriving comprehensive options for action. The findings of the economic based value chain analysis and ecologically-oriented water footprint analysis on regional level were complemented with the findings of an input-output model on national level. This combination gave an added value for better-informed decision-making to reach land, water and ecosystem sustainability, compared to the individual results of each approach. The synergy of approaches pointed at various options for actions, such as to (i) promote the shift of water use from the high water consuming agricultural sector to a less water consuming cotton processing sector, (ii) increase overall water use efficiency by expanding the highly water productive industrial sectors and concurrently decreasing sectors with inefficient water use, and (iii) reduce agricultural water use by improving irrigation and conveyance efficiencies. The findings showed that increasing water use efficiency, manufacturing products with higher value added and raising water users' awareness of the real value of water are essential for providing water security in Uzbekistan.

A profile of the online dissemination of national influenza surveillance data

PubMed Central

Cheng, Calvin KY; Lau, Eric HY; Ip, Dennis KM; Yeung, Alfred SY; Ho, Lai Ming; Cowling, Benjamin J

2009-01-01

Background Influenza surveillance systems provide important and timely information to health service providers on trends in the circulation of influenza virus and other upper respiratory tract infections. Online dissemination of surveillance data is useful for risk communication to health care professionals, the media and the general public. We reviewed national influenza surveillance websites from around the world to describe the main features of surveillance data dissemination. Methods We searched for national influenza surveillance websites for every country and reviewed the resulting sites where available during the period from November 2008 through February 2009. Literature about influenza surveillance was searched at MEDLINE for relevant hyperlinks to related websites. Non-English websites were translated into English using human translators or Google language tools. Results A total of 70 national influenza surveillance websites were identified. The percentage of developing countries with surveillance websites was lower than that of developed countries (22% versus 57% respectively). Most of the websites (74%) were in English or provided an English version. The most common surveillance methods included influenza-like illness consultation rates in primary care settings (89%) and laboratory surveillance (44%). Most websites (70%) provided data within a static report format and 66% of the websites provided data with at least weekly resolution. Conclusion Appropriate dissemination of surveillance data is important to maximize the utility of collected data. There may be room for improvement in the style and content of the dissemination of influenza data to health care professionals and the general public. PMID:19754978

[Hospital infection surveillance in 5 Roman intensive care units].

PubMed

Orsi, G B; Raponi, M; Sticca, G; Branca, L; Scalise, E; Franchi, C; Venditti, M; Fara, G M

2003-01-01

The A.A. carried out a survey on hospital acquired infection (HAI) in the intensive care units (ICU) of five roman hospitals. The study monitored the following site-specific infection rates: pneumonia (PNE), blood stream infections (BSI), urinary tract infections (UTI), surgical site infections (SSI). According to CDC definitions all patients developing infection 48 hours or more after ward admission were included. Furthermore risk factors (i.e. age, sex, SAPS II), invasive procedures (i.e. endotracheal intubation, vascular and urinary catheterisation), microbiological isolates and their antibiotic susceptibility were screened. The overall 503 patients characteristics (i.e., age, length of stay, case-mix...) showed the wards as general ICU's. Although the SAPS II score was similar, mortality (18.2%-42.9%) and general infection rates (15.4%-40.4%) among the five ICU's were considerably variable (p < 0.05), as HAI episodes distribution by type: PNE (37-88%), BSI (6-42%), UTI (6-24%), SSI (3-7%) (p < 0.05). Also device-associated infection rates such as Ventilator-associated PNE (11.6-24.6@1000), Vascular catheter-associated BSI (3.4-19.2@1000). Urinary catheter-associated UTI (2.6-14.0@1000) and invasive procedures management were different. Among the infected patients the most commonly isolated microorganisms were P. aeruginosa and Staphylococcus spp., which presented a considerable antibiotic resistance. The study showed: 1) sampling (i.e. blood cultures, tracheal aspirate and urine samples) and laboratory methodology indispensable for a correct HAI diagnosis were not standardized in the five ICU's; 2) hospital infection control policy was not carried out in all ICU's. The study showed a lack of standardization which limits the comparability of the general roman ICU's.

Editorial brain malformation surveillance in the Zika era

PubMed Central

Trevathan, Edwin

2016-01-01

The current surveillance systems for congenital microcephaly are necessary to monitor the impact of Zika virus (ZIKV) on the developing human brain, as well as the ZIKV prevention efforts. However, these congenital microcephaly surveillance systems are insufficient. Abnormalities of neuronal differentiation, development and migration may occur among infants with normal head circumference who have intrauterine exposure to ZIKV. Therefore, surveillance for congenital microcephaly does not ascertain many of the infants seriously impacted by congenital ZIKV infection. Furthermore, many infants with normal head circumference and with malformations of the brain cortex do not have clinical manifestations of their congenital malformations until several months to many years after birth, when they present with clinical manifestations such as seizures/epilepsy, developmental delays with or without developmental regression, and/or motor impairment. In response to the ZIKV threat, public health surveillance systems must be enhanced to ascertain a wide variety of congenital brain malformations, as well as their clinical manifestations that lead to diagnostic brain imaging. Birth Defects Research (Part A) 106:869–874, 2016. © 2016 The Authors Birth Defects Research Part A: Clinical and Molecular Teratology Published by Wiley Periodicals, Inc. PMID:27891785

Rotavirus gastroenteritis surveillance in Azerbaijan, 2011-2016.

PubMed

Mursalova, Nazifa; Shugayev, Nazim; Suleymanova, Javahir; Daniels, Danni S; Wasley, Annemarie; Cohen, Adam L; Aliabadi, Negar

2018-05-18

Rotavirus is a leading cause of acute gastroenteritis and mortality among children worldwide but data describing rotavirus disease in Azerbaijan are lacking. This analysis describes the rotavirus disease burden in Baku, the largest city in Azerbaijan. We conducted active, prospective, sentinel hospital surveillance with laboratory confirmation for rotavirus among children under 5 years of age hospitalized at a large pediatric hospital in Baku during 2011-2016. Children with bloody diarrhea, or prior use of antibiotics or intravenous fluids were excluded. The guardians of enrolled children completed a questionnaire documenting clinical and demographic information. A stool specimen was collected from each enrolled child. We report the number and proportion of rotavirus positive hospitalizations during the surveillance period and a clinical description of rotavirus-positive and rotavirus-negative children. From July 2011 through June 2016, 3139 children <5 years of age were enrolled into the surveillance system. Of these, 523 (17%) were positive for rotavirus, varying from 13% to 21% by surveillance year, with a median of 16% over the surveillance period. Increase in rotavirus detections occurred during December-May. Most rotavirus infections (303/523; 58%) occurred in children aged 6-23 months. Rotavirus is responsible for approximately 16% of annual hospital admissions for acute gastroenteritis in children <5 years of age in Baku. This is lower than regional estimates. Exclusion of children with a history of antibiotic use or intravenous fluids may be accounting for this lower prevalence, and expansion of surveillance to include these groups could provide a more comprehensive picture of acute rotavirus gastroenteritis in Baku. Published by Elsevier Ltd.

Seroincidence of human infections with nontyphoid Salmonella compared with data from public health surveillance and food animals in 13 European countries.

PubMed

Mølbak, Kåre; Simonsen, Jacob; Jørgensen, Charlotte S; Krogfelt, Karen A; Falkenhorst, Gerhard; Ethelberg, Steen; Takkinen, Johanna; Emborg, Hanne-Dorthe

2014-12-01

We developed a model that enabled a back-calculation of the annual salmonellosis seroincidence from measurements of Salmonella antibodies and applied this model to 9677 serum samples collected from populations in 13 European countries. We found a 10-fold difference in the seroincidence, which was lowest in Sweden (0.06 infections per person-year), Finland (0.07), and Denmark (0.08) and highest in Spain (0.61), followed by Poland (0.55). These numbers were not correlated with the reported national incidence of Salmonella infections in humans but were correlated with prevalence data of Salmonella in laying hens (P < .001), broilers (P < .001), and slaughter pigs (P = .03). Seroincidence also correlated with Swedish data on the country-specific risk of travel-associated Salmonella infections (P = .001). Estimates based on seroepidemiological methods are well suited to measure the force of transmission of Salmonella to human populations, in particular relevant for assessments where data include notifications from areas, states or countries with diverse characteristics of the Salmonella surveillance. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Surveillance of healthcare associated infections in pediatric cancer patients between 2004 and 2009 in a public pediatric hospital in Mexico city, Mexico.

PubMed

Hernández Orozco, Hilda; Lucas Resendiz, Esperanza; Castañeda, Jose Luis; De Colsa, Agustin; Ramirez Mayans, Jaime; Johnson, Kyle M; Gonzalez, Napoleon; Caniza, Miguela A

2014-03-01

Pediatric oncology and hematology patients are at increased risk of developing healthcare associated infections (HAIs). We conducted a prospective surveillance study on children with cancer admitted to the pediatric hematology and oncology units at a public pediatric hospital in Mexico from January 2004 to December 2009. The incidence of HAIs and groups at greatest risk for HAIs were analyzed. The annual HAI incidence rate and incidence density were calculated. Risk factors such as site of infection, HAI types, and cancer diagnosis were studied. A total of 9420 patients participated, and 409 had HAIs (479 episodes). Annual HAI rates were 3.7 to 5.5 per 100 admissions and the incidence density was 5.75 to 6 HAIs per 1000 inpatient days annually. There were 272 (56.8%) bloodstream infections, 45 (9.4%) pneumonia cases, and 44 (9.2%) skin and soft tissue infections. Children with acute lymphoblastic leukemia had 37.2% and those with acute myeloid leukemia had 16.4% of the HAIs. A total of 11.5% of the HAIs were in children with osteosarcoma. The most common pathogens were Gram-negative bacteria. The HAI-associated mortality rate was 3.7%. Although the overall HAI rate is in line with published reports, the mortality rate was higher, suggesting the incorporation of more aggressive methods to treat infections at our hospital.

Impact of a multidimensional infection control approach on central line-associated bloodstream infections rates in adult intensive care units of 8 cities of Turkey: findings of the International Nosocomial Infection Control Consortium (INICC)

PubMed Central

2013-01-01

Background Central line-associated bloodstream infections (CLABs) have long been associated with excess lengths of stay, increased hospital costs and mortality attributable to them. Different studies from developed countries have shown that practice bundles reduce the incidence of CLAB in intensive care units. However, the impact of the bundle strategy has not been systematically analyzed in the adult intensive care unit (ICU) setting in developing countries, such as Turkey. The aim of this study is to analyze the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional infection control approach to reduce the rates of CLAB in 13 ICUs of 13 INICC member hospitals from 8 cities of Turkey. Methods We conducted active, prospective surveillance before-after study to determine CLAB rates in a cohort of 4,017 adults hospitalized in ICUs. We applied the definitions of the CDC/NHSN and INICC surveillance methods. The study was divided into baseline and intervention periods. During baseline, active outcome surveillance of CLAB rates was performed. During intervention, the INICC multidimensional approach for CLAB reduction was implemented and included the following measures: 1- bundle of infection control interventions, 2- education, 3- outcome surveillance, 4- process surveillance, 5- feedback of CLAB rates, and 6- performance feedback on infection control practices. CLAB rates obtained in baseline were compared with CLAB rates obtained during intervention. Results During baseline, 3,129 central line (CL) days were recorded, and during intervention, we recorded 23,463 CL-days. We used random effects Poisson regression to account for clustering of CLAB rates within hospital across time periods. The baseline CLAB rate was 22.7 per 1000 CL days, which was decreased during the intervention period to 12.0 CLABs per 1000 CL days (IRR 0.613; 95% CI 0.43 – 0.87; P 0.007). This amounted to a 39% reduction in the incidence rate of CLAB

Possible Zika Virus Infection Among Pregnant Women - United States and Territories, May 2016.

PubMed

Simeone, Regina M; Shapiro-Mendoza, Carrie K; Meaney-Delman, Dana; Petersen, Emily E; Galang, Romeo R; Oduyebo, Titilope; Rivera-Garcia, Brenda; Valencia-Prado, Miguel; Newsome, Kimberly B; Pérez-Padilla, Janice; Williams, Tonya R; Biggerstaff, Matthew; Jamieson, Denise J; Honein, Margaret A

2016-05-27

Zika virus is a cause of microcephaly and brain abnormalities (1), and it is the first known mosquito-borne infection to cause congenital anomalies in humans. The establishment of a comprehensive surveillance system to monitor pregnant women with Zika virus infection will provide data to further elucidate the full range of potential outcomes for fetuses and infants of mothers with asymptomatic and symptomatic Zika virus infection during pregnancy. In February 2016, Zika virus disease and congenital Zika virus infections became nationally notifiable conditions in the United States (2). Cases in pregnant women with laboratory evidence of Zika virus infection who have either 1) symptomatic infection or 2) asymptomatic infection with diagnosed complications of pregnancy can be reported as cases of Zika virus disease to ArboNET* (2), CDC's national arboviral diseases surveillance system. Under existing interim guidelines from the Council for State and Territorial Epidemiologists (CSTE), asymptomatic Zika virus infections in pregnant women who do not have known pregnancy complications are not reportable. ArboNET does not currently include pregnancy surveillance information (e.g., gestational age or pregnancy exposures) or pregnancy outcomes. To understand the full impact of infection on the fetus and neonate, other systems are needed for reporting and active monitoring of pregnant women with laboratory evidence of possible Zika virus infection during pregnancy. Thus, in collaboration with state, local, tribal, and territorial health departments, CDC established two surveillance systems to monitor pregnancies and congenital outcomes among women with laboratory evidence of Zika virus infection(†) in the United States and territories: 1) the U.S. Zika Pregnancy Registry (USZPR),(§) which monitors pregnant women residing in U.S. states and all U.S. territories except Puerto Rico, and 2) the Zika Active Pregnancy Surveillance System (ZAPSS), which monitors pregnant women

Technical, economic, and environmental impact study of converting Uzbekistan transportation fleets to natural gas operation. Export trade information

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1997-04-30

This study, conducted by Radian International, was funded by the U.S. Trade and Development Agency. The report assesses the feasibility (technical, economic and environmental) of converting the Uzbek transportation fleets to natural gas operation. The study focuses on the conversion of high fuel use vehicles and locomotives to liquefied natural gas (LNG) and the conversion of moderate fuel use veicles to compressed natural gas (CNG). The report is divided into the following sections: Executive Summary; (1.0) Introduction; (2.0) Country Background; (3.0) Characterization of Uzbek Transportation Fuels; (4.0) Uzbek Vehicle and Locomotive Fleet Characterization; (5.0) Uzbek Natural Gas Vehicle Conversion Shops;more » (6.0) Uzbek Natural Gas Infrastructure; (7.0) Liquefied Natural Gas (LNG) for Vehicular Fuel in Uzbekistan; (8.0) Economic Feasibility Study; (9.0) Environmental Impact Analysis; References; Appendices A - S.« less

Geology and structural evolution of the Muruntau gold deposit, Kyzylkum desert, Uzbekistan

USGS Publications Warehouse

Drew, L.J.; Berger, B.R.; Kurbanov, N.K.

1996-01-01

The Muruntau gold deposit in the Kyzylkum desert of Uzbekistan is the largest single deposit (??? 1100 tonnes of gold) of the class of low-sulfide syndeformation/synigenous gold deposits formed in the brittle/ductile transition zone of the crust within transpressional shear zones. Hosted by the Cambrian to Ordovician Besopan Suite, the ores were deposited in pre-existing thrust-fault- and metamorphism-related permeabilities and in synmineralization dilational zones created in a large fault-related fold. The Besopan Suite is a 5,000-m-thick sequence of turbiditic siltstones, shales and sandstones. The ore is primarily localized at the base of the Besopan-3 unit, which is a 2,000-m-thick series of carbonaceous shales, siltstones, sandstones and cherts. Initial gold deposition took place within the Sangruntau-Tamdytau shear zone, which was developed along the stratigraphic contact between the Besopan-3 and Besopan-4 units. During the mineralization process, folding of the Besopan Suite and a left-step adjustment in the Sangruntau-Tamdytau shear zone were caused by two concurrent events: (1) the activation of the left-lateral Muruntau-Daugyztau shear zone that developed at nearly a 90?? angle to the preceding shear zone and (2) the intrusion of granitoid plutons. These structural events also resulted in the refocusing of hydrothermal fluid flow into new zones of permeability.

Avian Influenza Virus A (H5N1), Detected through Routine Surveillance, in Child, Bangladesh

PubMed Central

Alamgir, A.S.M.; Sultana, Rebecca; Islam, M. Saiful; Rahman, Mustafizur; Fry, Alicia M.; Shu, Bo; Lindstrom, Stephen; Nahar, Kamrun; Goswami, Doli; Haider, M. Sabbir; Nahar, Sharifun; Butler, Ebonee; Hancock, Kathy; Donis, Ruben O.; Davis, Charles T.; Zaman, Rashid Uz; Luby, Stephen P.; Uyeki, Timothy M.; Rahman, Mahmudur

2009-01-01

We identified avian influenza virus A (H5N1) infection in a child in Bangladesh in 2008 by routine influenza surveillance. The virus was of the same clade and phylogenetic subgroup as that circulating among poultry during the period. This case illustrates the value of routine surveillance for detection of novel influenza virus. PMID:19751601

A reassessment of the referral of an isolated skull from the latecretaceous of Uzbekistan to the stem-testudinoid turtlelindholmemys

DOE Office of Scientific and Technical Information (OSTI.GOV)

Danilov, Igor G.; Parham, James F.

2005-12-01

A fossil turtle skull (ZISP PH 1/17) from the LateCretaceous (upper Turonian, Bissekty Formation) of Dzharakuduk(Uzbekistan, Asia) was used to score the skull characters for the genusLindholmemys (a stem testudinoid) in a recent phylogenetic analysis. Adescription of ZISP PH 1/17 and a new cladistic analysis reveals nocharacters to support its referral to Lindholmemys elegans or to thestem-testudinoid lineage. ZISP PH 1/17 is very similar to North AmericanAdocus, differing mainly in characters of the upper jaw. Therefore, wehypothesize that ZISP PH 1/17 is the skull of either Shachemysancestralis or "Adocus" aksary, adocid shell taxa from Dzharakuduk.Pending additional discoveries and description ofmore » turtles fromDzharakuduk, we refer ZISP PH 1/17 to Adocidae, gen. et sp.indet.« less

Evaluation of the national surveillance system for point-prevalence of healthcare-associated infections in hospitals and in long-term care facilities for elderly in Norway, 2002-2008

PubMed Central

2011-01-01

Background Since 2002, the Norwegian Institute of Public Health has invited all hospitals and long-term care facilities for elderly (LTCFs) to participate in two annual point-prevalence surveys covering the most frequent types of healthcare-associated infections (HAIs). In a comprehensive evaluation we assessed how well the system operates to meet its objectives. Methods Surveillance protocols and the national database were reviewed. Data managers at national level, infection control practitioners and ward personnel in hospitals as well as contact persons in LTCFs involved in prevalence data collection were surveyed. Results The evaluation showed that the system was structurally simple, flexible and accepted by the key partners. On average 87% of hospitals and 32% of LTCFs participated in 2004-2008; high level of data completeness was achieved. The data collected described trends in the prevalence of reportable HAIs in Norway and informed policy makers. Local results were used in hospitals to implement targeted infection control measures and to argue for more resources to a greater extent than in LTCFs. Both the use of simplified Centers for Disease Control and Prevention (CDC) definitions and validity of data seemed problematic as compliance with the standard methodology were reportedly low. Conclusions The surveillance system provides important information on selected HAIs in Norway. The system is overall functional and well-established in hospitals, however, requires active promotion in LTCFs. Validity of data needs to be controlled in the participating institutions before reporting to the national level. PMID:22165849

Surveillance and laboratory detection for non-polio enteroviruses in the European Union/European Economic Area, 2016

PubMed Central

Harvala, Heli; Jasir, Aftab; Penttinen, Pasi; Pastore Celentano, Lucia; Greco, Donato; Broberg, Eeva

2017-01-01

Enteroviruses (EVs) cause severe outbreaks of respiratory and neurological disease as illustrated by EV-D68 and EV-A71 outbreaks, respectively. We have mapped European laboratory capacity for identification and characterisation of non-polio EVs to improve preparedness to respond to (re)-emerging EVs linked to severe disease. An online questionnaire on non-polio EV surveillance and laboratory detection was submitted to all 30 European Union (EU)/European Economic Area (EEA) countries. Twenty-nine countries responded; 26 conducted laboratory-based non-polio EV surveillance, and 24 included neurological infections in their surveillance. Eleven countries have established specific surveillance for EV-D68 via sentinel influenza surveillance (n = 7), typing EV-positive respiratory samples (n = 10) and/or acute flaccid paralysis surveillance (n = 5). Of 26 countries performing non-polio EV characterisation/typing, 10 further characterised culture-positive EV isolates, whereas the remainder typed PCR-positive but culture-negative samples. Although 19 countries have introduced sequence-based EV typing, seven still rely entirely on virus isolation. Based on 2015 data, six countries typed over 300 specimens mostly by sequencing, whereas 11 countries characterised under 50 EV-positive samples. EV surveillance activity varied between EU/EEA countries, and did not always specifically target patients with neurological and/or respiratory infections. Introduction of sequence-based typing methods is needed throughout the EU/EEA to enhance laboratory capacity for the detection of EVs. PMID:29162204

Surveillance and laboratory detection for non-polio enteroviruses in the European Union/European Economic Area, 2016.

PubMed

Harvala, Heli; Jasir, Aftab; Penttinen, Pasi; Pastore Celentano, Lucia; Greco, Donato; Broberg, Eeva

2017-11-01

Enteroviruses (EVs) cause severe outbreaks of respiratory and neurological disease as illustrated by EV-D68 and EV-A71 outbreaks, respectively. We have mapped European laboratory capacity for identification and characterisation of non-polio EVs to improve preparedness to respond to (re)-emerging EVs linked to severe disease. An online questionnaire on non-polio EV surveillance and laboratory detection was submitted to all 30 European Union (EU)/European Economic Area (EEA) countries. Twenty-nine countries responded; 26 conducted laboratory-based non-polio EV surveillance, and 24 included neurological infections in their surveillance. Eleven countries have established specific surveillance for EV-D68 via sentinel influenza surveillance (n = 7), typing EV-positive respiratory samples (n = 10) and/or acute flaccid paralysis surveillance (n = 5). Of 26 countries performing non-polio EV characterisation/typing, 10 further characterised culture-positive EV isolates, whereas the remainder typed PCR-positive but culture-negative samples. Although 19 countries have introduced sequence-based EV typing, seven still rely entirely on virus isolation. Based on 2015 data, six countries typed over 300 specimens mostly by sequencing, whereas 11 countries characterised under 50 EV-positive samples. EV surveillance activity varied between EU/EEA countries, and did not always specifically target patients with neurological and/or respiratory infections. Introduction of sequence-based typing methods is needed throughout the EU/EEA to enhance laboratory capacity for the detection of EVs.

Integrating gender and sex to unpack trends in sexually transmitted infection surveillance data in British Columbia, Canada: an ethno-epidemiological study

PubMed Central

Knight, Rod; Falasinnu, Titilola; Oliffe, John L; Gilbert, Mark; Small, Will; Goldenberg, Shira; Shoveller, Jean

2016-01-01

Objectives Surveillance data frequently indicate that young men and women experience high—yet considerably different—reported rates of sexually transmitted infections (STIs), including bacterial infections such as chlamydia. We examined how several sex-based (eg, biological) and gender-based (eg, sociocultural) factors may interact to influence STI surveillance data trends. Methods Employing ethno-epidemiological techniques, we analysed cross-sectional qualitative data collected between 2006 and 2013 about young people's experiences accessing STI testing services in five communities in British Columbia, Canada. These data included 250 semistructured interviews with young men and women aged 15–24 years, as well as 39 clinicians who provided STI testing services. Results The findings highlight how young women are socially and medically encouraged to regularly test, while young men are rarely offered similar opportunities. Instead, young men tend to seek out testing services: (1) at the beginning or end of a sexual relationship; (2) after a high-risk sexual encounter; (3) after experiencing symptoms; or (4) based on concerns about ‘abnormal’ sexual anatomy. Our results illustrate how institutions and individuals align with stereotypical gender norms regarding sexual health responsibilities, STI testing and STI treatments. While these patterns reflect social phenomena, they also appear to intersect with sex-based, biological experiences of symptomatology in ways that might help to further explain systematic differences between young men's and women's patterns of testing for STIs. Conclusions The results point to the importance of taking a social and biological view to understanding the factors that contribute to the gap between young men's and women's routine engagement in STI care. PMID:27566628

Viruses Associated With Acute Respiratory Infections and Influenza-like Illness Among Outpatients From the Influenza Incidence Surveillance Project, 2010–2011

PubMed Central

Fowlkes, Ashley; Giorgi, Andrea; Erdman, Dean; Temte, Jon; Goodin, Kate; Di Lonardo, Steve; Sun, Yumei; Martin, Karen; Feist, Michelle; Linz, Rachel; Boulton, Rachelle; Bancroft, Elizabeth; McHugh, Lisa; Lojo, Jose; Filbert, Kimberly; Finelli, Lyn

2017-01-01

Background The Influenza Incidence Surveillance Project (IISP) monitored outpatient acute respiratory infection (ARI; defined as the presence of ≥2 respiratory symptoms not meeting ILI criteria) and influenza-like illness (ILI) to determine the incidence and contribution of associated viral etiologies. Methods From August 2010 through July 2011, 57 outpatient healthcare providers in 12 US sites reported weekly the number of visits for ILI and ARI and collected respiratory specimens on a subset for viral testing. The incidence was estimated using the number of patients in the practice as the denominator, and the virus-specific incidence of clinic visits was extrapolated from the proportion of patients testing positive. Results The age-adjusted cumulative incidence of outpatient visits for ARI and ILI combined was 95/1000 persons, with a viral etiology identified in 58% of specimens. Most frequently detected were rhinoviruses/enteroviruses (RV/EV) (21%) and influenza viruses (21%); the resulting extrapolated incidence of outpatient visits was 20 and 19/1000 persons respectively. The incidence of influenza virus-associated clinic visits was highest among patients aged 2–17 years, whereas other viruses had varied patterns among age groups. Conclusions The IISP provides a unique opportunity to estimate the outpatient respiratory illness burden by etiology. Influenza virus infection and RV/EV infection(s) represent a substantial burden of respiratory disease in the US outpatient setting, particularly among children. PMID:24338352

[Multicentre study of infection incidence in knee prosthesis].

PubMed

Jaén, F; Sanz-Gallardo, M I; Arrazola, M P; García de Codes, A; de Juanes, A; Resines, C

2012-01-01

To determine the incidence of surgical site infection in knee prosthesis surgical procedure for a follow-up period of one year in twelve hospitals in Madrid region. A prospective study was carried out from January to December 2009 using a national surveillance system called Indicadores Clínicos de Mejora Continua de Calidad. Primary and revision knee joint replacements in patients operated on in the previous year were included. Criteria used to define surgical site infection and patient risk index categories were those established by the Centers for Disease Control and Prevention and National Nosocomial Infections Surveillance. The incidence rates were worked out crude and adjusted by hazard ratio. 2,088 knee prosthesis procedures were analyzed. The overall incidence of surgical site infection was 2.1%. Sixty-five percent of the infections were organ/space. Sixty percent of the infections were identified in the early postoperative period. Of all surgical site infections, 41.9% were microbiologically confirmed. Antibiotic prophylaxis was implemented correctly in 63.3% of the cases. The most important cause of inappropriate prophylaxis was an unsuitable duration in 85.7% of the cases. The presurgical preparation was carried out correctly in 50.3% of surgical operations. The incidence of knee arthroplasty infection was twice as high as in the National Healthcare Safety Network and similar to national rates. In this study, the incidence of infection was within the range of infection rates in other published European studies. Surveillance and control strategies of health care for associated infections allow us to assess trends and the impact of preventive measures. Copyright © 2011 SECOT. Published by Elsevier Espana. All rights reserved.

Establishing a cost-effective national surveillance system for Bluetongue using scenario tree modelling.

PubMed

Hadorn, Daniela C; Racloz, Vanessa; Schwermer, Heinzpeter; Stärk, Katharina D C

2009-01-01

Vector-borne diseases pose a special challenge to veterinary authorities due to complex and time-consuming surveillance programs taking into account vector habitat. Using stochastic scenario tree modelling, each possible surveillance activity of a future surveillance system can be evaluated with regard to its sensitivity and the expected cost. The overall sensitivity of various potential surveillance systems, composed of different combinations of surveillance activities, is calculated and the proposed surveillance system is optimized with respect to the considered surveillance activities, the sensitivity and the cost. The objective of this project was to use stochastic scenario tree modelling in combination with a simple cost analysis in order to develop the national surveillance system for Bluetongue in Switzerland. This surveillance system was established due to the emerging outbreak of Bluetongue virus serotype 8 (BTV-8) in Northern Europe in 2006. Based on the modelling results, it was decided to implement an improved passive clinical surveillance in cattle and sheep through campaigns in order to increase disease awareness alongside a targeted bulk milk testing strategy in 200 dairy cattle herds located in high-risk areas. The estimated median probability of detection of cases (i.e. sensitivity) of the surveillance system in this combined approach was 96.4%. The evaluation of the prospective national surveillance system predicted that passive clinical surveillance in cattle would provide the highest probability to detect BTV-8 infected animals, followed by passive clinical surveillance in sheep and bulk milk testing of 200 dairy cattle farms in high-risk areas. This approach is also applicable in other countries and to other epidemic diseases.

Sieve analysis using the number of infecting pathogens.

PubMed

Follmann, Dean; Huang, Chiung-Yu

2017-12-14

Assessment of vaccine efficacy as a function of the similarity of the infecting pathogen to the vaccine is an important scientific goal. Characterization of pathogen strains for which vaccine efficacy is low can increase understanding of the vaccine's mechanism of action and offer targets for vaccine improvement. Traditional sieve analysis estimates differential vaccine efficacy using a single identifiable pathogen for each subject. The similarity between this single entity and the vaccine immunogen is quantified, for example, by exact match or number of mismatched amino acids. With new technology, we can now obtain the actual count of genetically distinct pathogens that infect an individual. Let F be the number of distinct features of a species of pathogen. We assume a log-linear model for the expected number of infecting pathogens with feature "f," f=1,…,F. The model can be used directly in studies with passive surveillance of infections where the count of each type of pathogen is recorded at the end of some interval, or active surveillance where the time of infection is known. For active surveillance, we additionally assume that a proportional intensity model applies to the time of potentially infectious exposures and derive product and weighted estimating equation (WEE) estimators for the regression parameters in the log-linear model. The WEE estimator explicitly allows for waning vaccine efficacy and time-varying distributions of pathogens. We give conditions where sieve parameters have a per-exposure interpretation under passive surveillance. We evaluate the methods by simulation and analyze a phase III trial of a malaria vaccine. © 2017, The International Biometric Society.

Assessment of undiscovered oil and gas resources of the Amu Darya Basin and Afghan-Tajik Basin Provinces, Afghanistan, Iran, Tajikistan, Turkmenistan, and Uzbekistan, 2011

USGS Publications Warehouse

Klett, T.R.; Schenk, Christopher J.; Wandrey, Craig J.; Charpentier, Ronald R.; Brownfield, Michael E.; Pitman, Janet K.; Pollastro, Richard M.; Cook, Troy A.; Tennyson, Marilyn E.

2012-01-01

Using a geology-based assessment methodology, the U.S. Geological Survey estimated volumes of undiscovered, technically recoverable, conventional petroleum resources for the Amu Darya Basin and Afghan–Tajik Basin Provinces of Afghanistan, Iran, Tajikistan, Turkmenistan, and Uzbekistan. The mean volumes were estimated at 962 million barrels of crude oil, 52 trillion cubic feet of natural gas, and 582 million barrels of natural gas liquids for the Amu Darya Basin Province and at 946 million barrels of crude oil, 7 trillion cubic feet of natural gas, and 85 million barrels of natural gas liquids for the Afghan–Tajik Basin Province.

An Integrated Syndromic Surveillance System for Monitoring Scarlet Fever in Taiwan

PubMed Central

Wu, Wan-Jen; Liu, Yu-Lun; Kuo, Hung-Wei; Huang, Wan-Ting; Yang, Shiang-Lin; Chuang, Jen-Hsiang

2013-01-01

Objective To develop an integrated syndromic surveillance system for timely monitoring and early detection of unusual situations of scarlet fever in Taiwan, since Hong Kong, being so close geographically to Taiwan, had an outbreak of scarlet fever in June 2011. Introduction Scarlet fever is a bacterial infection caused by group A streptococcus (GAS). The clinical symptoms are usually mild. Before October, 2007, case-based surveillance of scarlet fever was conducted through notifiable infectious diseases in Taiwan, but was removed later from the list of notifiable disease because of improved medical care capacities. In 2011, Hong Kong had encountered an outbreak of scarlet fever (1,2). In response, Taiwan developed an integrated syndromic surveillance system using multiple data sources since July 2011. Methods More than 99% of the Taiwan population is covered by National Health Insurance. We first retrospectively evaluated claims data from the Bureau of National Health Insurance (BNHI) by comparing with notifiable diseases reporting data from Taiwan Centers for Disease Control (TCDC). The claims data included information on scarlet fever diagnosis (ICD-9-CM code 034.1), date of visits, location of hospitals and age of patients from outpatient (OPD), emergency room (ER) and hospital admissions. Daily aggregate data of scarlet fever visits or hospitalizations were prospectively collected from BNHI since July 2011. Over 70% of the deaths in Taiwan are reported to the Office of Statistics of Department of Health electronically. We obtained daily data on electronic death certification data and used SAS Enterprise Guide 4.3 (SAS Institute Inc., Cary, NC, USA) for data management and analysis. Deaths associated with scarlet fever or other GAS infections were identified by text mining from causes of death with keywords of traditional Chinese ‘scarlet fever’, ‘group A streptococcus’ or ‘toxic shock syndrome’ (3). Results From January 2006 to September 2007, the

Two years of surveillance of influenza a virus infection in a swine herd. Results of virological, serological and pathological studies.

PubMed

Cappuccio, Javier; Dibarbora, Marina; Lozada, Inés; Quiroga, Alejandra; Olivera, Valeria; Dángelo, Marta; Pérez, Estefanía; Barrales, Hernán; Perfumo, Carlos; Pereda, Ariel; Pérez, Daniel R

2017-02-01

Swine farms provide a dynamic environment for the evolution of influenza A viruses (IAVs). The present report shows the results of a surveillance effort of IAV infection in one commercial swine farm in Argentina. Two cross-sectional serological and virological studies (n=480) were carried out in 2011 and 2012. Virus shedding was detected in nasal samples from pigs from ages 7, 21 and 42-days old. More than 90% of sows and gilts but less than 40% of 21-days old piglets had antibodies against IAV. In addition, IAV was detected in 8/17 nasal swabs and 10/15 lung samples taken from necropsied pigs. A subset of these samples was further processed for virus isolation resulting in 6 viruses of the H1N2 subtype (δ2 cluster). Pathological studies revealed an association between suppurative bronchopneumonia and necrotizing bronchiolitis with IAV positive samples. Statistical analyses showed that the degree of lesions in bronchi, bronchiole, and alveoli was higher in lungs positive to IAV. The results of this study depict the relevance of continuing long-term active surveillance of IAV in swine populations to establish IAV evolution relevant to swine and humans. Copyright © 2016 Elsevier Ltd. All rights reserved.

HIV-1 Transmission during Early Infection in Men Who Have Sex with Men: A Phylodynamic Analysis

DOE PAGES

Volz, Erik M.; Ionides, Edward; Romero-Severson, Ethan O.; ...

2013-12-10

Conventional epidemiological surveillance of infectious diseases is focused on characterization of incident infections and estimation of the number of prevalent infections. Advances in methods for the analysis of the population-level genetic variation of viruses can potentially provide information about donors, not just recipients, of infection. Genetic sequences from many viruses are increasingly abundant, especially HIV, which is routinely sequenced for surveillance of drug resistance mutations. In this study, we conducted a phylodynamic analysis of HIV genetic sequence data and surveillance data from a US population of men who have sex with men (MSM) and estimated incidence and transmission rates bymore » stage of infection.« less

HIV-1 Transmission during Early Infection in Men Who Have Sex with Men: A Phylodynamic Analysis

DOE Office of Scientific and Technical Information (OSTI.GOV)

Volz, Erik M.; Ionides, Edward; Romero-Severson, Ethan O.

Conventional epidemiological surveillance of infectious diseases is focused on characterization of incident infections and estimation of the number of prevalent infections. Advances in methods for the analysis of the population-level genetic variation of viruses can potentially provide information about donors, not just recipients, of infection. Genetic sequences from many viruses are increasingly abundant, especially HIV, which is routinely sequenced for surveillance of drug resistance mutations. In this study, we conducted a phylodynamic analysis of HIV genetic sequence data and surveillance data from a US population of men who have sex with men (MSM) and estimated incidence and transmission rates bymore » stage of infection.« less

Complementary surveillance strategies are needed to better characterise the epidemiology, care pathways and treatment outcomes of tuberculosis in children.

PubMed

du Preez, Karen; Schaaf, H Simon; Dunbar, Rory; Walters, Elisabetta; Swartz, Alvera; Solomons, Regan; Hesseling, Anneke C

2018-03-23

Tuberculosis (TB) in young and HIV-infected children is frequently diagnosed at hospital level. In settings where general hospitals do not function as TB reporting units, the burden and severity of childhood TB may not be accurately reflected in routine TB surveillance data. Given the paucibacillary nature of childhood TB, microbiological surveillance alone will miss the majority of hospital-managed children. The study objective was to combine complementary hospital-based surveillance strategies to accurately report the burden, spectrum and outcomes of childhood TB managed at referral hospital-level in a high TB burden setting. We conducted a prospective cohort study including all children (< 13 years) managed for TB at a large referral hospital in Cape Town, South Africa during 2012. Children were identified through newly implemented clinical surveillance in addition to existing laboratory surveillance. Data were collected from clinical patient records, the National Health Laboratory Service database, and provincial electronic TB registers. Descriptive statistics were used to report overall TB disease burden, spectrum, care pathways and treatment outcomes. Univariate analysis compared characteristics between children identified through the two hospital-based surveillance strategies to characterise the group of children missed by existing laboratory surveillance. During 2012, 395 children (180 [45.6%] < 2 years) were managed for TB. Clinical surveillance identified 237 (60%) children in addition to laboratory surveillance. Ninety (24.3%) children were HIV co-infected; 113 (29.5%) had weight-for-age z-scores <- 3. Extra-pulmonary TB (EPTB) was diagnosed in 188 (47.6%); 77 (19.5%) with disseminated TB. Favourable TB treatment outcomes were reported in 300/344 (87.2%) children with drug-susceptible and 50/51 (98.0%) children with drug-resistant TB. Older children (OR 1.7; 95% CI 1.0-2.8), children with EPTB (OR 2.3; 95% CI 1.5-3.6) and in-hospital deaths (OR 5

Epidemiological HIV infection surveillance among subjects with risk behaviours in the city of Messina (Sicily) from 1992 to 2015.

PubMed

Visalli, G; Avventuroso, E; Laganà, P; Spataro, P; Di Pietro, A; Bertuccio, M P; Picerno, I

2017-09-01

Epidemiological studies are a key element in determining the evolution and spread of HIV infection among the world population. Knowledge of the epidemiological dynamics improves strategies for prevention and monitoring. We examined 2,272 subjects who voluntarily underwent HIV testing from January 1992 to December 2015. For each subject, an anonymous form was completed to obtain information on personal data, sexual habits and exposure to risk factors. The number of subjects undergoing the screening test has increased over the years and the average age of the tested subjects has decreased over time. The main motivation for undergoing HIV testing is unprotected sex. Although heterosexual subjects taking the test were more numerous than homosexuals in this study, an increase in the latter over time should be highlighted. Although the number of tests performed has increased over the years, the persistence of unprotected sex shows an inadequate perception of risk. Therefore, it is necessary to implement programmes to increase the general awareness of HIV infection. It is also essential to undertake constant monitoring of behaviour, risk perception and the application of the screening test via surveillance systems in order to implement effective and efficient prevention.

Locating People Diagnosed With HIV for Public Health Action: Utility of HIV Case Surveillance and Other Data Sources.

PubMed

Padilla, Mabel; Mattson, Christine L; Scheer, Susan; Udeagu, Chi-Chi N; Buskin, Susan E; Hughes, Alison J; Jaenicke, Thomas; Wohl, Amy Rock; Prejean, Joseph; Wei, Stanley C

Human immunodeficiency virus (HIV) case surveillance and other health care databases are increasingly being used for public health action, which has the potential to optimize the health outcomes of people living with HIV (PLWH). However, often PLWH cannot be located based on the contact information available in these data sources. We assessed the accuracy of contact information for PLWH in HIV case surveillance and additional data sources and whether time since diagnosis was associated with accurate contact information in HIV case surveillance and successful contact. The Case Surveillance-Based Sampling (CSBS) project was a pilot HIV surveillance system that selected a random population-based sample of people diagnosed with HIV from HIV case surveillance registries in 5 state and metropolitan areas. From November 2012 through June 2014, CSBS staff members attempted to locate and interview 1800 sampled people and used 22 data sources to search for contact information. Among 1063 contacted PLWH, HIV case surveillance data provided accurate telephone number, address, or HIV care facility information for 239 (22%), 412 (39%), and 827 (78%) sampled people, respectively. CSBS staff members used additional data sources, such as support services and commercial people-search databases, to locate and contact PLWH with insufficient contact information in HIV case surveillance. PLWH diagnosed <1 year ago were more likely to have accurate contact information in HIV case surveillance than were PLWH diagnosed ≥1 year ago ( P = .002), and the benefit from using additional data sources was greater for PLWH with more longstanding HIV infection ( P < .001). When HIV case surveillance cannot provide accurate contact information, health departments can prioritize searching additional data sources, especially for people with more longstanding HIV infection.

Epidemiology and microbiology of nosocomial bloodstream infections: analysis of 482 cases from a retrospective surveillance study*

PubMed Central

Wu, Jian-nong; Gan, Tie-er; Zhu, Yue-xian; Cao, Jun-min; Ji, Cong-hua; Wu, Yi-hua; Lv, Bin

2015-01-01

In many traditional Chinese medicine (TCM) hospitals, most patients are elderly with chronic diseases. Nosocomial bloodstream infections (nBSIs) are an important cause of morbidity and mortality. A retrospective surveillance study was performed to examine the epidemiology and microbiology of nBSIs in a TCM hospital from 2009 to 2011. A total of 482 patients with nBSIs were included in the study period. The incidence rate was 5.7/1000 admissions. Escherichia coli (25.5%) was the most common Gram-negative and coagulase-negative staphylococcus (CoNS) (14.1%) was the most common Gram-positive organism isolated. One-third of the E. coli and Klebsiella pneumoniae isolated from the nBSIs were the third-generation cephalosporin-resistant. Half of the Acinetobacter species isolates were resistant to imipenem. Of all the CoNS isolates, 90.7% were resistant to methicillin. Carbapenems and glycopeptide were the most frequently used for nBSI therapy. Only about one-third of patients (157/482) received appropriate empirical therapy. Septic shock, hemodialysis, Pitt bacteremia score >4, urinary tract infection, and appropriate empirical therapy were most strongly associated with 28-d mortality. The incidence of nBSIs was low in the TCM hospital but the proportion of nBSIs due to antibiotic-resistant organisms was high. A high Pitt bacteremia score was one of the most important risk factors for mortality in nBSIs. Therefore, the implementation of appropriate empirical therapy is crucial to improve the clinical outcome of nBSIs. PMID:25559958

A clinical data repository enhances hospital infection control.

PubMed Central

Samore, M.; Lichtenberg, D.; Saubermann, L.; Kawachi, C.; Carmeli, Y.

1997-01-01

We describe the benefits of a relational database of hospital clinical data (Clinical Data Repository; CDR) for an infection control program. The CDR consists of > 40 Sybase tables, and is directly accessible for ad hoc queries by members of the infection control unit who have been granted privileges for access by the Information Systems Department. The data elements and functional requirements most useful for surveillance of nosocomial infections, antibiotic use, and resistant organisms are characterized. Specific applications of the CDR are presented, including the use of automated definitions of nosocomial infection, graphical monitoring of resistant organisms with quality control limits, and prospective detection of inappropriate antibiotic use. Hospital surveillance and quality improvement activities are significantly benefited by the availability of a querable set of tables containing diverse clinical data. PMID:9357588

Enhanced West Nile Virus Surveillance in a Dengue-Endemic Area—Puerto Rico, 2007

PubMed Central

Torres-Aponte, Jomil M.; Luce, Richard R.; Hunsperger, Elizabeth; Muñoz-Jordan, Jorge L.; Beltrán, Manuela; Vergne, Edgardo; Argüello, D. Fermín; García, Enid J.; Sun, Wellington; Tomashek, Kay M.

2013-01-01

In June of 2007, West Nile virus (WNV) was detected in sentinel chickens and blood donors in Puerto Rico, where dengue virus (DENV) is hyperendemic. Enhanced human surveillance for acute febrile illness (AFI) began in eastern Puerto Rico on July 1, 2007. Healthcare providers submitted specimens from AFI cases for WNV and DENV virology and serology testing. Over 6 months, 385 specimens were received from 282 cases; 115 (41%) specimens were DENV laboratory-positive, 86 (31%) specimens were laboratory-indeterminate, and 32 (11%) specimens were laboratory-negative for WNV and DENV. One WNV infection was detected by anti-WNV immunoglobulin M (IgM) antibody and confirmed by a plaque reduction neutralization test. DENV and WNV infections could not be differentiated in 27 cases (10%). During a period of active WNV transmission, enhanced human surveillance identified one case of symptomatic WNV infection. Improved diagnostic methods are needed to allow differentiation of WNV and DENV in dengue-endemic regions. PMID:23478583

Incidence of Lower Respiratory Tract Infections and Atopic Conditions in Boys and Young Male Adults: Royal College of General Practitioners Research and Surveillance Centre Annual Report 2015-2016.

PubMed

de Lusignan, Simon; Correa, Ana; Pebody, Richard; Yonova, Ivelina; Smith, Gillian; Byford, Rachel; Pathirannehelage, Sameera Rankiri; McGee, Christopher; Elliot, Alex J; Hriskova, Mariya; Ferreira, Filipa Im; Rafi, Imran; Jones, Simon

2018-04-30

The Royal College of General Practitioners Research and Surveillance Centre comprises more than 150 general practices, with a combined population of more than 1.5 million, contributing to UK and European public health surveillance and research. The aim of this paper was to report gender differences in the presentation of infectious and respiratory conditions in children and young adults. Disease incidence data were used to test the hypothesis that boys up to puberty present more with lower respiratory tract infection (LRTI) and asthma. Incidence rates were reported for infectious conditions in children and young adults by gender. We controlled for ethnicity, deprivation, and consultation rates. We report odds ratios (OR) with 95% CI, P values, and probability of presenting. Boys presented more with LRTI, largely due to acute bronchitis. The OR of males consulting was greater across the youngest 3 age bands (OR 1.59, 95% CI 1.35-1.87; OR 1.13, 95% CI 1.05-1.21; OR 1.20, 95% CI 1.09-1.32). Allergic rhinitis and asthma had a higher OR of presenting in boys aged 5 to 14 years (OR 1.52, 95% CI 1.37-1.68; OR 1.31, 95% CI 1.17-1.48). Upper respiratory tract infection (URTI) and urinary tract infection (UTI) had lower odds of presenting in boys, especially those older than 15 years. The probability of presenting showed different patterns for LRTI, URTI, and atopic conditions. Boys younger than 15 years have greater odds of presenting with LRTI and atopic conditions, whereas girls may present more with URTI and UTI. These differences may provide insights into disease mechanisms and for health service planning. ©Simon de Lusignan, Ana Correa, Richard Pebody, Ivelina Yonova, Gillian Smith, Rachel Byford, Sameera Rankiri Pathirannehelage, Christopher McGee, Alex J. Elliot, Mariya Hriskova, Filipa IM Ferreira, Imran Rafi, Simon Jones. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 30.04.2018.

Surveillance of microcephaly and selected brain anomalies in Argentina: Relationship with Zika virus and other congenital infections.

PubMed

Tellechea, Ana Laura; Luppo, Victoria; Morales, María Alejandra; Groisman, Boris; Baricalla, Agustin; Fabbri, Cintia; Sinchi, Anabel; Alonso, Alicia; Gonzalez, Cecilia; Ledesma, Bibiana; Masi, Patricia; Silva, María; Israilev, Adriana; Rocha, Marcela; Quaglia, Marcela; Bidondo, María Paz; Liascovich, Rosa; Barbero, Pablo

2018-06-19

Zika virus (ZIKV) vertical transmission may lead to microcephaly and other congenital anomalies. In March and April 2016, the first outbreak of ZIKV occurred in Argentina. The objective was to describe the surveillance of newborns with microcephaly and other selected brain anomalies in Argentina, and evaluation different etiologies. Participants were enrolled between April 2016 and March 2017. newborns from the National Network of Congenital Abnormalities of Argentina (RENAC) with head circumference lower than the 3rd percentile according to gestational age and sex, or selected brain anomalies. Blood and urine samples from cases and their mothers were tested for ZIKV by real-time polymerase chain reaction (RT-PCR), antigen-specific Immunoglobulin M (MAC-ELISA) and plaque-reduction neutralization test (PRNT 90 ). Toxoplasmosis, rubella, herpes simplex, syphilis, and cytomegalovirus (CMV) infection were also tested. A total of 104 cases were reported, with a prevalence of 6.9 per 10,000 [95% confidence interval (CI): 5.7-8.4], a significant increase when compared with the data prior to 2016, Prevalence Rate Ratio 1.7 (95% CI 1.2-2.3). In five cases positive serology for ZIKV (IgM and IgG by PRNT) was detected. The five cases presented microcephaly with craniofacial disproportion. We detected four cases of CMV infection, three cases of congenital toxoplasmosis, two cases of herpes simplex infection, and one case of congenital syphilis. The prevalence of microcephaly was significantly higher when compared with the previous period. The system had the capacity to detect five cases with congenital ZIKV syndrome in a country with limited viral circulation. © 2018 Wiley Periodicals, Inc.

[Changing medical practices and nosocomial infection rates in French maternity units from 1997 to 2000].

PubMed

Vincent-Boulétreau, A; Caillat-Vallet, E; Dumas, A M; Ayzac, L; Chapuis, C; Emery, M N; Girard, R; Haond, C; Lafarge-Leboucher, J; Tissot-Guerraz, F; Fabry, J

2005-04-01

In this study we describe the changes in medical practices and nosocomial infection rates in obstetrics observed through a surveillance network in the South East of France. The maternity units which belong to this network participated in voluntary surveillance using the network's methodology. The criteria for the diagnosis of nosocomial infections were in accordance with the methods described by the Centers for Disease Control and Prevention. 101240 pregnancies including 18503 caesareans (18.3%) were included in the network from 1997 to 2000. During the study period, nosocomial infection rates following caesarean section and vaginal delivery decreased respectively from 7.8% to 4.3% (p < 0.001) and from 2.2% to 0.9% (p < 0.001). This evolution was compared with the evolution of collected risk factors. In spite of the methodology limits, general value of surveillance and infection control programs in maternity units has been confirmed by the results of this surveillance network. During the study period, both obstetrics-related risk factors for nosocomial infection and observed hospital-acquired infection rates were dramatically reduced, what prove an improvement of quality of care in maternity units.

Visual Analytics of Surveillance Data on Foodborne Vibriosis, United States, 1973–2010

PubMed Central

Sims, Jennifer N.; Isokpehi, Raphael D.; Cooper, Gabrielle A.; Bass, Michael P.; Brown, Shyretha D.; St John, Alison L.; Gulig, Paul A.; Cohly, Hari H.P.

2011-01-01

Foodborne illnesses caused by microbial and chemical contaminants in food are a substantial health burden worldwide. In 2007, human vibriosis (non-cholera Vibrio infections) became a notifiable disease in the United States. In addition, Vibrio species are among the 31 major known pathogens transmitted through food in the United States. Diverse surveillance systems for foodborne pathogens also track outbreaks, illnesses, hospitalization and deaths due to non-cholera vibrios. Considering the recognition of vibriosis as a notifiable disease in the United States and the availability of diverse surveillance systems, there is a need for the development of easily deployed visualization and analysis approaches that can combine diverse data sources in an interactive manner. Current efforts to address this need are still limited. Visual analytics is an iterative process conducted via visual interfaces that involves collecting information, data preprocessing, knowledge representation, interaction, and decision making. We have utilized public domain outbreak and surveillance data sources covering 1973 to 2010, as well as visual analytics software to demonstrate integrated and interactive visualizations of data on foodborne outbreaks and surveillance of Vibrio species. Through the data visualization, we were able to identify unique patterns and/or novel relationships within and across datasets regarding (i) causative agent; (ii) foodborne outbreaks and illness per state; (iii) location of infection; (iv) vehicle (food) of infection; (v) anatomical site of isolation of Vibrio species; (vi) patients and complications of vibriosis; (vii) incidence of laboratory-confirmed vibriosis and V. parahaemolyticus outbreaks. The additional use of emerging visual analytics approaches for interaction with data on vibriosis, including non-foodborne related disease, can guide disease control and prevention as well as ongoing outbreak investigations. PMID:22174586

The cost and cost-effectiveness of rapid testing strategies for yaws diagnosis and surveillance.

PubMed

Fitzpatrick, Christopher; Asiedu, Kingsley; Sands, Anita; Gonzalez Pena, Tita; Marks, Michael; Mitja, Oriol; Meheus, Filip; Van der Stuyft, Patrick

2017-10-01

Yaws is a non-venereal treponemal infection caused by Treponema pallidum subspecies pertenue. The disease is targeted by WHO for eradication by 2020. Rapid diagnostic tests (RDTs) are envisaged for confirmation of clinical cases during treatment campaigns and for certification of the interruption of transmission. Yaws testing requires both treponemal (trep) and non-treponemal (non-trep) assays for diagnosis of current infection. We evaluate a sequential testing strategy (using a treponemal RDT before a trep/non-trep RDT) in terms of cost and cost-effectiveness, relative to a single-assay combined testing strategy (using the trep/non-trep RDT alone), for two use cases: individual diagnosis and community surveillance. We use cohort decision analysis to examine the diagnostic and cost outcomes. We estimate cost and cost-effectiveness of the alternative testing strategies at different levels of prevalence of past/current infection and current infection under each use case. We take the perspective of the global yaws eradication programme. We calculate the total number of correct diagnoses for each strategy over a range of plausible prevalences. We employ probabilistic sensitivity analysis (PSA) to account for uncertainty and report 95% intervals. At current prices of the treponemal and trep/non-trep RDTs, the sequential strategy is cost-saving for individual diagnosis at prevalence of past/current infection less than 85% (81-90); it is cost-saving for surveillance at less than 100%. The threshold price of the trep/non-trep RDT (below which the sequential strategy would no longer be cost-saving) is US$ 1.08 (1.02-1.14) for individual diagnosis at high prevalence of past/current infection (51%) and US$ 0.54 (0.52-0.56) for community surveillance at low prevalence (15%). We find that the sequential strategy is cost-saving for both diagnosis and surveillance in most relevant settings. In the absence of evidence assessing relative performance (sensitivity and specificity

Impact of an International Nosocomial Infection Control Consortium multidimensional approach on catheter-associated urinary tract infections in adult intensive care units in the Philippines: International Nosocomial Infection Control Consortium (INICC) findings.

PubMed

Navoa-Ng, Josephine Anne; Berba, Regina; Rosenthal, Victor D; Villanueva, Victoria D; Tolentino, María Corazon V; Genuino, Glenn Angelo S; Consunji, Rafael J; Mantaring, Jacinto Blas V

2013-10-01

To assess the impact of a multidimensional infection control approach on the reduction of catheter-associated urinary tract infection (CAUTI) rates in adult intensive care units (AICUs) in two hospitals in the Philippines that are members of the International Nosocomial Infection Control Consortium. This was a before-after prospective active surveillance study to determine the rates of CAUTI in 3183 patients hospitalized in 4 ICUS over 14,426 bed-days. The study was divided into baseline and intervention periods. During baseline, surveillance was performed using the definitions of the US Centers for Disease Control and Prevention and the National Healthcare Safety Network (CDC/NHSN). During intervention, we implemented a multidimensional approach that included: (1) a bundle of infection control interventions, (2) education, (3) surveillance of CAUTI rates, (4) feedback on CAUTI rates, (5) process surveillance and (6) performance feedback. We used random effects Poisson regression to account for the clustering of CAUTI rates across time. We recorded 8720 urinary catheter (UC)-days: 819 at baseline and 7901 during intervention. The rate of CAUTI was 11.0 per 1000 UC-days at baseline and was decreased by 76% to 2.66 per 1000 UC-days during intervention [rate ratio [RR], 0.24; 95% confidence interval [CI], 0.11-0.53; P-value, 0.0001]. Our multidimensional approach was associated with a significant reduction in the CAUTI rates in the ICU setting of a limited-resource country. Copyright © 2013 King Saud Bin Abdulaziz University for Health Sciences. Published by Elsevier Ltd. All rights reserved.

Impact of a multidimensional infection control strategy on catheter-associated urinary tract infection rates in the adult intensive care units of 15 developing countries: findings of the International Nosocomial Infection Control Consortium (INICC).

PubMed

Rosenthal, V D; Todi, S K; Álvarez-Moreno, C; Pawar, M; Karlekar, A; Zeggwagh, A A; Mitrev, Z; Udwadia, F E; Navoa-Ng, J A; Chakravarthy, M; Salomao, R; Sahu, S; Dilek, A; Kanj, S S; Guanche-Garcell, H; Cuéllar, L E; Ersoz, G; Nevzat-Yalcin, A; Jaggi, N; Medeiros, E A; Ye, G; Akan, Ö A; Mapp, T; Castañeda-Sabogal, A; Matta-Cortés, L; Sirmatel, F; Olarte, N; Torres-Hernández, H; Barahona-Guzmán, N; Fernández-Hidalgo, R; Villamil-Gómez, W; Sztokhamer, D; Forciniti, S; Berba, R; Turgut, H; Bin, C; Yang, Y; Pérez-Serrato, I; Lastra, C E; Singh, S; Ozdemir, D; Ulusoy, S

2012-10-01

We aimed to evaluate the impact of a multidimensional infection control strategy for the reduction of the incidence of catheter-associated urinary tract infection (CAUTI) in patients hospitalized in adult intensive care units (AICUs) of hospitals which are members of the International Nosocomial Infection Control Consortium (INICC), from 40 cities of 15 developing countries: Argentina, Brazil, China, Colombia, Costa Rica, Cuba, India, Lebanon, Macedonia, Mexico, Morocco, Panama, Peru, Philippines, and Turkey. We conducted a prospective before-after surveillance study of CAUTI rates on 56,429 patients hospitalized in 57 AICUs, during 360,667 bed-days. The study was divided into the baseline period (Phase 1) and the intervention period (Phase 2). In Phase 1, active surveillance was performed. In Phase 2, we implemented a multidimensional infection control approach that included: (1) a bundle of preventive measures, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback of CAUTI rates, and (6) feedback of performance. The rates of CAUTI obtained in Phase 1 were compared with the rates obtained in Phase 2, after interventions were implemented. We recorded 253,122 urinary catheter (UC)-days: 30,390 in Phase 1 and 222,732 in Phase 2. In Phase 1, before the intervention, the CAUTI rate was 7.86 per 1,000 UC-days, and in Phase 2, after intervention, the rate of CAUTI decreased to 4.95 per 1,000 UC-days [relative risk (RR) 0.63 (95% confidence interval [CI] 0.55-0.72)], showing a 37% rate reduction. Our study showed that the implementation of a multidimensional infection control strategy is associated with a significant reduction in the CAUTI rate in AICUs from developing countries.

Analysis of the surveillance situation for viral encephalitis and meningitis in Europe.

PubMed

Donoso Mantke, O; Vaheri, A; Ambrose, H; Koopmans, M; de Ory, F; Zeller, H; Beyrer, K; Windorfer, A; Niedrig, M

2008-01-17

Infective processes in the brain, spinal cord and meninges are considered to be the main causes of encephalitis, myelitis and meningitis. However, most cases remain unexplained. The incidence of different viral aetiologies (zoonotic and non-zoonotic) is especially poorly estimated, due to the lack of a standard case definition and of agreed diagnostic algorithms, including harmonised diagnostic methods and sample collection. It is important to clarify the incidence of viral encephalitis/meningitis and to optimise the diagnosis of infectious neurological illness, particularly to ensure early recognition of outbreaks or emerging infectious such a West Nile encephalitis. The European Network for Diagnostics of 'Imported' Viral Diseases (ENIVD) has analysed the present surveillance situation for viral encephalitis/meningitis in Europe. Here we give an overview of the existing epidemiological sources of information in European Union (EU) Member States, mapping the laboratory capacity and identifying key requirements for a possible future surveillance study at European level. The data presented will help design a harmonised/standardised Europe-wide surveillance study investigating patients with encephalitis and/or meningitis in order to obtain more information on the role of infections in these rarely analysed syndromes, both from a clinical and an epidemiological perspective.

Influence of border disease virus (BDV) on serological surveillance within the bovine virus diarrhea (BVD) eradication program in Switzerland.

PubMed

Kaiser, V; Nebel, L; Schüpbach-Regula, G; Zanoni, R G; Schweizer, M

2017-01-13

In 2008, a program to eradicate bovine virus diarrhea (BVD) in cattle in Switzerland was initiated. After targeted elimination of persistently infected animals that represent the main virus reservoir, the absence of BVD is surveilled serologically since 2012. In view of steadily decreasing pestivirus seroprevalence in the cattle population, the susceptibility for (re-) infection by border disease (BD) virus mainly from small ruminants increases. Due to serological cross-reactivity of pestiviruses, serological surveillance of BVD by ELISA does not distinguish between BVD and BD virus as source of infection. In this work the cross-serum neutralisation test (SNT) procedure was adapted to the epidemiological situation in Switzerland by the use of three pestiviruses, i.e., strains representing the subgenotype BVDV-1a, BVDV-1h and BDSwiss-a, for adequate differentiation between BVDV and BDV. Thereby the BDV-seroprevalence in seropositive cattle in Switzerland was determined for the first time. Out of 1,555 seropositive blood samples taken from cattle in the frame of the surveillance program, a total of 104 samples (6.7%) reacted with significantly higher titers against BDV than BVDV. These samples originated from 65 farms and encompassed 15 different cantons with the highest BDV-seroprevalence found in Central Switzerland. On the base of epidemiological information collected by questionnaire in case- and control farms, common housing of cattle and sheep was identified as the most significant risk factor for BDV infection in cattle by logistic regression. This indicates that pestiviruses from sheep should be considered as a source of infection of domestic cattle and might well impede serological BVD surveillance.

Importance of Enhanced Surveillance for Prevention of Pertussis in Children.

PubMed

Domínguez, Angela; Godoy, Pere; Toledo, Diana; Soldevila, Núria; García-Cenoz, Manuel; Farrús, Gloria; Crespo, Inma; Caylà, Joan A; Sala, Maria Rosa; Camps, Neus; Barrabeig, Irene; Alvarez, Josep

2015-07-01

Bordetella pertussis infection causes considerable morbidity, even in countries with high vaccination coverage. Surveillance of pertussis is usually passive and based on mandatory reporting. We assessed the epidemiologic and clinical characteristics of pertussis cases detected by passive or enhanced surveillance. A prospective population-based study was carried out from January 2012 to December 2013 in Catalonia and Navarre, 2 Spanish regions with a total population of 8.2 million. For each confirmed case, variables of age, sex, clinical symptoms, laboratory results and vaccination status were investigated. Associations between the variables studied and the type of surveillance were assessed by odds ratio (OR) and its 95% confidence interval (CI). Logistic regression was used to estimate adjusted OR (aOR). In children <18 years of age, passive surveillance was the most important source of detection (95.7% in <1 year). In children 5-10 years of age, passive surveillance detected 67.5% of cases. In those ≥18 years, enhanced surveillance was the most frequent source of case detection (82.5%). Inspiratory whoop (aOR: 1.94; 95% CI: 1.40-2.70), apnea (aOR: 1.92; 95% CI: 1.28-2.87) and posttussive vomiting (aOR: 1.43; 95% CI: 1.04-1.96) were symptoms included in the clinical case definition that were associated with passive surveillance. Underreporting of symptomatic cases is important not only in adults, but also in children >1 year of age and suggests that providing clinics with free, fast laboratory diagnostic tests, together with enhanced surveillance of family contacts of any age is necessary to better determine existing cases. Enhanced surveillance may be helpful to better understand transmission patterns in the family and in the community.

[Legionnaire's disease: surveillance in France in 2005].

PubMed

Campèse, C; Jarraud, S; Che, D

2007-11-01

Legionnaire's disease is a recently described infection and surveillance in France was implemented in 1987. In 2005, 1,527 cases were notified corresponding to a population incidence rate of 2.5 per 100,000. The median age of cases was 61 years [5-100] and the male to female sex ratio was 3.0. The case fatality rate was 11%. One or more risk factors were identified for 1,084 (71%) cases. The majority of cases (91%) was diagnosed by urinary antigen detection and a strain was identified in 276 cases (18%). Legionella pneumophila serogroup 1 infection was confirmed in 95% of cases. A specific exposure during the incubation period was reported for 39% of cases. Travel exposure was reported for 17% and hospital exposure for 7%. Multiple clusters and outbreaks were investigated. The largest one reported was identified in the north Lyon with 34 cases. Since 1997 the incidence of LD has steadily increased. This probably suggests a better detection of cases and an improvement in the surveillance system. In recent years, several new measures concerning prevention and control were implemented. However these efforts must continue particularly in the research domain to improve knowledge of the disease, in order to limit its impact on exposed populations.

Integrating gender and sex to unpack trends in sexually transmitted infection surveillance data in British Columbia, Canada: an ethno-epidemiological study.

PubMed

Knight, Rod; Falasinnu, Titilola; Oliffe, John L; Gilbert, Mark; Small, Will; Goldenberg, Shira; Shoveller, Jean

2016-08-26

Surveillance data frequently indicate that young men and women experience high-yet considerably different-reported rates of sexually transmitted infections (STIs), including bacterial infections such as chlamydia. We examined how several sex-based (eg, biological) and gender-based (eg, sociocultural) factors may interact to influence STI surveillance data trends. Employing ethno-epidemiological techniques, we analysed cross-sectional qualitative data collected between 2006 and 2013 about young people's experiences accessing STI testing services in five communities in British Columbia, Canada. These data included 250 semistructured interviews with young men and women aged 15-24 years, as well as 39 clinicians who provided STI testing services. The findings highlight how young women are socially and medically encouraged to regularly test, while young men are rarely offered similar opportunities. Instead, young men tend to seek out testing services: (1) at the beginning or end of a sexual relationship; (2) after a high-risk sexual encounter; (3) after experiencing symptoms; or (4) based on concerns about 'abnormal' sexual anatomy. Our results illustrate how institutions and individuals align with stereotypical gender norms regarding sexual health responsibilities, STI testing and STI treatments. While these patterns reflect social phenomena, they also appear to intersect with sex-based, biological experiences of symptomatology in ways that might help to further explain systematic differences between young men's and women's patterns of testing for STIs. The results point to the importance of taking a social and biological view to understanding the factors that contribute to the gap between young men's and women's routine engagement in STI care. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Surveillance, control, and prevention of surgical site infections in breast cancer surgery: a 5-year experience.

PubMed

Vilar-Compte, Diana; Rosales, Samuel; Hernandez-Mello, Norma; Maafs, Eduardo; Volkow, Patricia

2009-10-01

We analyzed variations in surgical site infections (SSIs) during 5 years of a prospective surveillance program and investigated possible contributors to SSIs in a cohort of patients who underwent surgery for breast cancer. All breast surgeries performed between January 2001 and December 2005 were registered. Patients were followed-up by direct observation for at least 30 days under standardized conditions. The main outcome studied was SSI. A case-control analysis was conducted to identify SSI-associated risk factors and to evaluate SSI variations by means of a control chart. During the study period, a total of 2338 breast cancer surgeries were recorded, and 441 SSIs (18.9%) were diagnosed. SSI frequency varied across the 5-year period, with a sharp decline seen after the introduction of preventive policies. After 2002, 3 out-of-confidence limits of SSIs were observed, 2 related to the use of evacuation systems and 1 associated with a group of rotating residents. Concomitant preoperative chemoradiation (odds ratio [OR]=3.47; 95% confidence interval [CI]=2.51 to 4.80), hematoma (OR=3.05; 95% CI=1.70 to 5.52), age > or = 58 years (OR=1.83; 95% CI=1.27 to 2.65), body mass index > or = 30.8 (OR=1.58; 95% CI=1.14 to 2.18), and duration of surgery > or = 160 minutes (OR=1.73; 95% CI=1.20 to 2.50) were found to be SSI-associated risk factors. After 5 years of a continuous prospective surveillance program, we were able to decrease the rate of SSIs in patients undergoing breast cancer surgery (from 33.3% in 2000 to 18.9% in 2005), identify SSI-associated risk factors, and improve the quality of care delivered to these patients.

Expanding veterinary biosurveillance in Washington, DC: The creation and utilization of an electronic-based online veterinary surveillance system.

PubMed

Hennenfent, Andrew; DelVento, Vito; Davies-Cole, John; Johnson-Clarke, Fern

2017-03-01

To enhance the early detection of emerging infectious diseases and bioterrorism events using companion animal-based surveillance. Washington, DC, small animal veterinary facilities (n=17) were surveyed to determine interest in conducting infectious disease surveillance. Using these results, an electronic-based online reporting system was developed and launched in August 2015 to monitor rates of canine influenza, canine leptospirosis, antibiotic resistant infections, canine parvovirus, and syndromic disease trends. Nine of the 10 facilities that responded expressed interest conducting surveillance. In September 2015, 17 canine parvovirus cases were reported. In response, a campaign encouraging regular veterinary preventative care was launched and featured on local media platforms. Additionally, during the system's first year of operation it detected 5 canine leptospirosis cases and 2 antibiotic resistant infections. No canine influenza cases were reported and syndromic surveillance compliance varied, peaking during National Special Security Events. Small animal veterinarians and the general public are interested in companion animal disease surveillance. The system described can serve as a model for establishing similar systems to monitor disease trends of public health importance in pet populations and enhance biosurveillance capabilities. Copyright © 2017 Elsevier B.V. All rights reserved.

Operational research to inform a sub-national surveillance intervention for malaria elimination in Solomon Islands

PubMed Central

2012-01-01

Background Successful reduction of malaria transmission to very low levels has made Isabel Province, Solomon Islands, a target for early elimination by 2014. High malaria transmission in neighbouring provinces and the potential for local asymptomatic infections to cause malaria resurgence highlights the need for sub-national tailoring of surveillance interventions. This study contributes to a situational analysis of malaria in Isabel Province to inform an appropriate surveillance intervention. Methods A mixed method study was carried out in Isabel Province in late 2009 and early 2010. The quantitative component was a population-based prevalence survey of 8,554 people from 129 villages, which were selected using a spatially stratified sampling approach to achieve uniform geographical coverage of populated areas. Diagnosis was initially based on Giemsa-stained blood slides followed by molecular analysis using polymerase chain reaction (PCR). Local perceptions and practices related to management of fever and treatment-seeking that would impact a surveillance intervention were also explored using qualitative research methods. Results Approximately 33% (8,554/26,221) of the population of Isabel Province participated in the survey. Only one subject was found to be infected with Plasmodium falciparum (Pf) (96 parasites/μL) using Giemsa-stained blood films, giving a prevalence of 0.01%. PCR analysis detected a further 13 cases, giving an estimated malaria prevalence of 0.51%. There was a wide geographical distribution of infected subjects. None reported having travelled outside Isabel Province in the previous three months suggesting low-level indigenous malaria transmission. The qualitative findings provide warning signs that the current community vigilance approach to surveillance will not be sufficient to achieve elimination. In addition, fever severity is being used by individuals as an indicator for malaria and a trigger for timely treatment-seeking and case reporting

Operational research to inform a sub-national surveillance intervention for malaria elimination in Solomon Islands.

PubMed

Atkinson, Jo-An; Johnson, Marie-Louise; Wijesinghe, Rushika; Bobogare, Albino; Losi, L; O'Sullivan, Matthew; Yamaguchi, Yuka; Kenilorea, Geoffrey; Vallely, Andrew; Cheng, Qin; Ebringer, Andrew; Bain, Lisa; Gray, Karen; Harris, Ivor; Whittaker, Maxine; Reid, Heidi; Clements, Archie; Shanks, Dennis

2012-03-30

Successful reduction of malaria transmission to very low levels has made Isabel Province, Solomon Islands, a target for early elimination by 2014. High malaria transmission in neighbouring provinces and the potential for local asymptomatic infections to cause malaria resurgence highlights the need for sub-national tailoring of surveillance interventions. This study contributes to a situational analysis of malaria in Isabel Province to inform an appropriate surveillance intervention. A mixed method study was carried out in Isabel Province in late 2009 and early 2010. The quantitative component was a population-based prevalence survey of 8,554 people from 129 villages, which were selected using a spatially stratified sampling approach to achieve uniform geographical coverage of populated areas. Diagnosis was initially based on Giemsa-stained blood slides followed by molecular analysis using polymerase chain reaction (PCR). Local perceptions and practices related to management of fever and treatment-seeking that would impact a surveillance intervention were also explored using qualitative research methods. Approximately 33% (8,554/26,221) of the population of Isabel Province participated in the survey. Only one subject was found to be infected with Plasmodium falciparum (Pf) (96 parasites/μL) using Giemsa-stained blood films, giving a prevalence of 0.01%. PCR analysis detected a further 13 cases, giving an estimated malaria prevalence of 0.51%. There was a wide geographical distribution of infected subjects. None reported having travelled outside Isabel Province in the previous three months suggesting low-level indigenous malaria transmission. The qualitative findings provide warning signs that the current community vigilance approach to surveillance will not be sufficient to achieve elimination. In addition, fever severity is being used by individuals as an indicator for malaria and a trigger for timely treatment-seeking and case reporting. In light of the finding

Epidemiology of hepatocellular carcinoma: target population for surveillance and diagnosis.

PubMed

Tang, An; Hallouch, Oussama; Chernyak, Victoria; Kamaya, Aya; Sirlin, Claude B

2018-01-01

Hepatocellular carcinoma (HCC) is the sixth most common cancer and the second leading cause of cancer mortality worldwide. Incidence rates of liver cancer vary widely between geographic regions and are highest in Eastern Asia and sub-Saharan Africa. In the United States, the incidence of HCC has increased since the 1980s. HCC detection at an early stage through surveillance and curative therapy has considerably improved the 5-year survival. Therefore, medical societies advocate systematic screening and surveillance of target populations at particularly high risk for developing HCC to facilitate early-stage detection. Risk factors for HCC include cirrhosis, chronic infection with hepatitis B virus (HBV), hepatitis C virus (HCV), excess alcohol consumption, non-alcoholic fatty liver disease, family history of HCC, obesity, type 2 diabetes mellitus, and smoking. Medical societies utilize risk estimates to define target patient populations in which imaging surveillance is recommended (risk above threshold) or in which the benefits of surveillance are uncertain (risk unknown or below threshold). All medical societies currently recommend screening and surveillance in patients with cirrhosis and subsets of patients with chronic HBV; some societies also include patients with stage 3 fibrosis due to HCV as well as additional groups. Thus, target population definitions vary between regions, reflecting cultural, demographic, economic, healthcare priority, and biological differences. The Liver Imaging Reporting and Data System (LI-RADS) defines different patient populations for surveillance and for diagnosis and staging. We also discuss general trends pertaining to geographic region, age, gender, ethnicity, impact of surveillance on survival, mortality, and future trends.

Surveillance of infectious diseases in the Arctic.

PubMed

Bruce, M; Zulz, T; Koch, A

2016-08-01

This study reviews how social and environmental issues affect health in Arctic populations and describes infectious disease surveillance in Arctic Nations with a special focus on the activities of the International Circumpolar Surveillance (ICS) project. We reviewed the literature over the past 2 decades looking at Arctic living conditions and their effects on health and Arctic surveillance for infectious diseases. In regards to other regions worldwide, the Arctic climate and environment are extreme. Arctic and sub-Arctic populations live in markedly different social and physical environments compared to those of their more southern dwelling counterparts. A cold northern climate means people spending more time indoors, amplifying the effects of household crowding, smoking and inadequate ventilation on the person-to-person spread of infectious diseases. The spread of zoonotic infections north as the climate warms, emergence of antibiotic resistance among bacterial pathogens, the re-emergence of tuberculosis, the entrance of HIV into Arctic communities, the specter of pandemic influenza or the sudden emergence and introduction of new viral pathogens pose new challenges to residents, governments and public health authorities of all Arctic countries. ICS is a network of hospitals, public health agencies, and reference laboratories throughout the Arctic working together for the purposes of collecting, comparing and sharing of uniform laboratory and epidemiological data on infectious diseases of concern and assisting in the formulation of prevention and control strategies (Fig. 1). In addition, circumpolar infectious disease research workgroups and sentinel surveillance systems for bacterial and viral pathogens exist. The ICS system is a successful example of collaborative surveillance and research in an extreme environment. Published by Elsevier Ltd.

Risk-based methods for fish and terrestrial animal disease surveillance.

PubMed

Oidtmann, Birgit; Peeler, Edmund; Lyngstad, Trude; Brun, Edgar; Bang Jensen, Britt; Stärk, Katharina D C

2013-10-01

Over recent years there have been considerable methodological developments in the field of animal disease surveillance. The principles of risk analysis were conceptually applied to surveillance in order to further develop approaches and tools (scenario tree modelling) to design risk-based surveillance (RBS) programmes. In the terrestrial animal context, examples of risk-based surveillance have demonstrated the substantial potential for cost saving, and a similar benefit is expected also for aquatic animals. RBS approaches are currently largely absent for aquatic animal diseases. A major constraint in developing RBS designs in the aquatic context is the lack of published data to assist in the design of RBS: this applies to data on (i) the relative risk of farm sites becoming infected due to the presence or absence of a given risk factor; (ii) the sensitivity of diagnostic tests (specificity is often addressed by follow-up investigation and re-testing and therefore less of a concern); (iii) data on the variability of prevalence of infection for fish within a holding unit, between holding units and at farm level. Another constraint is that some of the most basic data for planning surveillance are missing, e.g. data on farm location and animal movements. In Europe, registration or authorisation of fish farms has only recently become a requirement under EU Directive 2006/88. Additionally, the definition of the epidemiological unit (at site or area level) in the context of aquaculture is a challenge due to the often high level of connectedness (mainly via water) of aquaculture facilities with the aquatic environment. This paper provides a review of the principles, methods and examples of RBS in terrestrial, farmed and wild animals. It discusses the special challenges associated with surveillance for aquatic animal diseases (e.g. accessibility of animals for inspection and sampling, complexity of rearing systems) and provides an overview of current developments relevant

AMR Surveillance in low and middle-income settings - A roadmap for participation in the Global Antimicrobial Surveillance System (GLASS)

PubMed Central

Seale, Anna C.; Gordon, N. Claire; Islam, Jasmin; Peacock, Sharon J.; Scott, J. Anthony G.

2017-01-01

Drug-resistant infections caused by bacteria with increasing antimicrobial resistance (AMR) threaten our ability to treat life-threatening conditions. Tackling AMR requires international collaboration and partnership. An early and leading priority to do this is to strengthen AMR surveillance, particularly in low-income countries where the burden of infectious diseases is highest and where data are most limited. The World Health Organization (WHO) has developed the Global AMR Surveillance System (GLASS) as one of a number of measures designed to tackle the problem of AMR, and WHO member states have been encouraged to produce National Action Plans for AMR by 2017. However, low-income countries are unlikely to have the resources or capacity to implement all the components in the GLASS manual. To facilitate their efforts, we developed a guideline that is aligned to the GLASS procedures, but written specifically for implementation in low-income countries. The guideline allows for flexibility across different systems, but has sufficient standardisation of core protocols to ensure that, if followed, data will be valid and comparable. This will ensure that the surveillance programme can provide health intelligence data to inform evidence-based interventions at local, national and international levels. PMID:29062918

Can near real-time monitoring of emergency department diagnoses facilitate early response to sporadic meningococcal infection? - prospective and retrospective evaluations

PubMed Central

2010-01-01

Background Meningococcal infection causes severe, rapidly progressing illness and reporting of cases is mandatory in New South Wales (NSW), Australia. The NSW Department of Health operates near real-time Emergency Department (ED) surveillance that includes capture and statistical analysis of clinical preliminary diagnoses. The system can provide alerts in response to specific diagnoses entered in the ED computer system. This study assessed whether once daily reporting of clinical diagnoses of meningococcal infection using the ED surveillance system provides an opportunity for timelier public health response for this disease. Methods The study involved a prospective and retrospective component. First, reporting of ED diagnoses of meningococcal infection from the ED surveillance system prospectively operated in parallel with conventional surveillance which requires direct telephone reporting of this scheduled medical condition to local public health authorities by hospitals and laboratories when a meningococcal infection diagnosis is made. Follow-up of the ED diagnoses determined whether meningococcal infection was confirmed, and the time difference between ED surveillance report and notification by conventional means. Second, cases of meningococcal infection reported by conventional surveillance during 2004 were retrospectively matched to ED visits to determine the sensitivity and positive predictive value (PPV) of ED surveillance. Results During the prospective evaluation, 31 patients were diagnosed with meningococcal infection in participating EDs. Of these, 12 had confirmed meningococcal disease, resulting in a PPV of 38.7%. All confirmed cases were notified earlier to public health authorities by conventional reporting. Of 149 cases of notified meningococcal disease identified retrospectively, 130 were linked to an ED visit. The sensitivity and PPV of the ED diagnosis for meningococcal infection was 36.2% and 36.7%, respectively. Conclusions Based on prospective

A seventeen-year epidemiological surveillance study of Borrelia burgdorferi infections in two provinces of northern Spain.

PubMed

Lledó, Lourdes; Gegúndez, María Isabel; Giménez-Pardo, Consuelo; Álamo, Rufino; Fernández-Soto, Pedro; Nuncio, María Sofia; Saz, José Vicente

2014-01-30

This paper reports a 17-year seroepidemiological surveillance study of Borrelia burgdorferi infection, performed with the aim of improving our knowledge of the epidemiology of this pathogen. Serum samples (1,179) from patients (623, stratified with respect to age, sex, season, area of residence and occupation) bitten by ticks in two regions of northern Spain were IFA-tested for B. burgdorferi antibodies. Positive results were confirmed by western blotting. Antibodies specific for B. burgdorferi were found in 13.3% of the patients; 7.8% were IgM positive, 9.6% were IgG positive, and 4.33% were both IgM and IgG positive. Five species of ticks were identified in the seropositive patients: Dermacentor marginatus (41.17% of such patients) Dermacentor reticulatus (11.76%), Rhiphicephalus sanguineus (17.64%), Rhiphicephalus turanicus (5.88%) and Ixodes ricinus (23.52%). B. burgdorferi DNA was sought by PCR in ticks when available. One tick, a D. reticulatus male, was found carrying the pathogen. The seroprevalence found was similar to the previously demonstrated in similar studies in Spain and other European countries.

Surgical wound infection rates in Spain: data summary, January 1997 through June 2012.

PubMed

Díaz-Agero Pérez, Cristina; Robustillo Rodela, Ana; Pita López, María José; López Fresneña, Nieves; Monge Jodrá, Vicente

2014-05-01

The Indicadores Clínicos de Mejora Continua de la Calidad (INCLIMECC) program was established in Spain in 1997. INCLIMECC is a prospective system of health care-associated infection (HAI) surveillance that collects incidence data in surgical and intensive care unit patients. The protocol is based on the National Healthcare Safety Network (NHSN) surveillance system, formerly known as the National Nosocomial Infection Surveillance (NNIS) system, and uses standard infection definitions from the US Centers for Disease Control and Prevention. Each hospital takes part voluntarily and selects the units and surgical procedures to be surveyed. This report is a summary of the data collected between January 1997 and June 2012. A total of 370,015 patients were included, and the overall incidence of surgical wound infection (SWI) was 4.51%. SWI rates are provided by NHSN operating procedure category and NNIS risk index category. More than 27% of the patients received inadequate antibiotic prophylaxis, the main reason being unsuitable duration (57.05% of cases). Today, the INCLIMECC network includes 64 Spanish hospitals. We believe that an HAI surveillance system with trained personnel external to the surveyed unit is a key component not only in infection control and prevention, but also in a quality improvement system. Copyright © 2014. Published by Mosby, Inc.

Outbreak of Legionnaires' disease on a cruise ship: lessons for international surveillance and control.

PubMed

Regan, C M; McCann, B; Syed, Q; Christie, P; Joseph, C; Colligan, J; McGaffin, A

2003-06-01

A sporadic case of Legionnaires' disease was linked to travel on a cruise ship. Investigation identified two further cases of Legionnaires' Disease and one case of non-pneumonic Legionella infection. An Incident Team confirmed the source to be the ship's water system and control measures were instituted that included pasteurisation, super chlorination and chlorine dioxide dosing. The Public Health Laboratory Service (PHLS) Communicable Disease Surveillance Centre (CDSC), through the European Surveillance Scheme for Travel Associated Legionnaires' Disease, identified three previous cases associated with the same ship's water system including one fatality. Lessons for the international surveillance and control of Legionnaires' disease on cruise ships are discussed.

Comparative evaluation of non-structural protein-antibody detecting ELISAs for foot-and-mouth disease sero-surveillance under intensive vaccination.

PubMed

Sharma, Gaurav Kumar; Mohapatra, Jajati Keshari; Mahajan, Sonalika; Matura, Rakesh; Subramaniam, Saravanan; Pattnaik, Bramhadev

2014-10-01

Foot-and-mouth disease is a highly infectious and contagious disease of livestock animals with transboundary and economical importance. Animals in the endemic settings are regularly vaccinated in addition to intensive surveillance for control of the disease. Under intensive vaccination, detection of infected animals among the vaccinated population is essential to monitor the infection and to track down the virus movement. Sero-surveillance and retrospective disease diagnosis is performed primarily by detecting antibodies against non-structural proteins (NSPs) of FMD virus which are usually absent in the inactivated vaccine formulations. The study was conducted with an objective to compare simultaneously performance of six NSP ELISAs in detecting infected animals in the areas covered under intensive vaccination, and to assess their fit-for-purpose attribute for sero-surveillance of FMD in India. A panel of bovine serum samples consisting of samples collected from infected with FMDV, vaccinated and naive animals were constituted. In addition, samples collected at random from areas having varied FMD situation and vaccination coverage were tested simultaneously by the six NSP ELISAs to compare their performances. The four indigenous assays showed varying degrees of correlation with the two commercial kits. The study validated that, in all the groups of samples, the indigenous assays were equally sensitive and specific as the two commercial kits. Among all the six assays, PrioCheck and in-house 3ABC I-ELISAs showed maximum sensitivity for detection of infected animals, whereas 3AB3 I-ELISA and 3ABC C-ELISA showed maximum specificity. The study concluded that the in-house available assays are equally capable as the commercially available kits for differentiation of infected animals under intensive vaccination and identifies the 3AB3 I-ELISA with optimum sensitivity and specificity for the purpose of sero-surveillance in India. Copyright © 2014 Elsevier B.V. All rights

Cryptosporidium surveillance and risk factors in the United States.

PubMed

Yoder, Jonathan S; Beach, Michael J

2010-01-01

Surveillance for Cryptosporidium in the United States indicates that the reported incidence of infection has increased dramatically since 2004. The reasons for this increase are unclear but might be caused by an actual increase in incidence, improved surveillance, improved awareness about cryptosporidiosis, and/or increases in testing practices resulting from the licensing of the first-ever treatment for cryptosporidiosis. While regional differences remain, the incidence of cryptosporidiosis appears to be increasing across the United States. Onset of illness is most common during the summer, particularly among younger children. Cryptosporidiosis case reporting also influences outbreak detection and reporting; the recent rise in cases coincides with an increase in the number of reported cryptosporidiosis outbreaks, particularly in treated recreational water venues. Risk factors include ingesting contaminated recreational or drinking water, exposure to infected animals, having close contacts with cryptosporidiosis, travel to disease-endemic areas, and ingestion of contaminated food. Advances in molecular characterization of clinical specimens have improved our understanding of the changing epidemiology and risk factors. Prevention and control of cryptosporidiosis requires continued efforts to interrupt the transmission of Cryptosporidium through water, food, and contact with infected persons or animals. Of particular importance is continued improvement and monitoring of drinking water treatment and advances in the design, operation, and management of recreational water venues coupled with behavioral changes among the swimming public. Published by Elsevier Inc.

Petroleum geology and resources of the North Ustyurt Basin, Kazakhstan and Uzbekistan

USGS Publications Warehouse

Ulmishek, Gregory F.

2001-01-01

The triangular-shaped North Ustyurt basin is located between the Caspian Sea and the Aral Lake in Kazakhstan and Uzbekistan and extends offshore both on the west and east. Along all its sides, the basin is bounded by the late Paleozoic and Triassic foldbelts that are partially overlain by Jurassic and younger rocks. The basin formed on a cratonic microcontinental block that was accreted northward to the Russian craton in Visean or Early Permian time. Continental collision and deformation along the southern and eastern basin margins occurred in Early Permian time. In Late Triassic time, the basin was subjected to strong compression that resulted in intrabasinal thrusting and faulting. Jurassic-Tertiary, mostly clastic rocks several hundred meters to 5 km thick overlie an older sequence of Devonian?Middle Carboniferous carbonates, Upper Precambrian massifs and deformed Caledonian foldbelts. The Carboniferous?Lower Permian clastics, carbonates, and volca-basement is at depths from 5.5 km on the highest uplifts to 11 nics, and Upper Permian?Triassic continental clastic rocks, pri-km in the deepest depressions. marily red beds. Paleogeographic conditions of sedimentation, Three total petroleum systems are identified in the basin. the distribution of rock types, and the thicknesses of pre-Triassic Combined volumes of discovered hydrocarbons in these sysstratigraphic units are poorly known because the rocks have been tems are nearly 2.4 billion barrels of oil and 2.4 trillion cubic penetrated by only a few wells in the western and eastern basin feet of gas. Almost all of the oil reserves are in the Buzachi Arch areas. The basement probably is heterogeneous; it includes and Surrounding Areas Composite Total Petroleum System in 2 Petroleum Geology, Resources?North Ustyurt Basin, Kazakhstan and Uzbekistan the western part of the basin. Oil pools are in shallow Jurassic and Neocomian sandstone reservoirs, in structural traps. Source rocks are absent in the total petroleum

Screening and surveillance. OSHA's medical surveillance provisions.

PubMed

Papp, E M; Miller, A S

2000-02-01

The OSH Act requires OSHA to include provisions for medical examinations of employees in its standards. However, the specific test and examinations criteria are not outlined in the OSH Act. Instead, each standard has specific medical surveillance requirements. These are specific to the adverse health effects triggered by exposure to the hazardous substance. The OSHA uses the term medical surveillance to refer to its employee examination and testing provisions. Most occupational health professionals call this activity employee screening and reserve the term surveillance for aggregate analysis of population data. It is important to remember this distinction when referring to OSHA standards. Many standards are challenged in court resulting in changes to medical surveillance provisions of the standards. Some court decisions support OSHA's language. In either case, the court often sets precedents for future standards.

Extragenital gonorrhea and chlamydia testing and infection among men who have sex with men--STD Surveillance Network, United States, 2010-2012.

PubMed

Patton, Monica E; Kidd, Sarah; Llata, Eloisa; Stenger, Mark; Braxton, Jim; Asbel, Lenore; Bernstein, Kyle; Gratzer, Beau; Jespersen, Megan; Kerani, Roxanne; Mettenbrink, Christie; Mohamed, Mukhtar; Pathela, Preeti; Schumacher, Christina; Stirland, Ali; Stover, Jeff; Tabidze, Irina; Kirkcaldy, Robert D; Weinstock, Hillard

2014-06-01

Gonorrhea (GC) and chlamydia (CT) are the most commonly reported notifiable diseases in the United States. The Centers for Disease Control and Prevention recommends that men who have sex with men (MSM) be screened for urogenital GC/CT, rectal GC/CT, and pharyngeal GC. We describe extragenital GC/CT testing and infections among MSM attending sexually transmitted disease (STD) clinics. The STD Surveillance Network collects patient data from 42 STD clinics. We assessed the proportion of MSM attending these clinics during July 2011-June 2012 who were tested and positive for extragenital GC/CT at their most recent visit or in the preceding 12 months and the number of extragenital infections that would have remained undetected with urethral screening alone. Of 21 994 MSM, 83.9% were tested for urogenital GC, 65.9% for pharyngeal GC, 50.4% for rectal GC, 81.4% for urogenital CT, 31.7% for pharyngeal CT, and 45.9% for rectal CT. Of MSM tested, 11.1% tested positive for urogenital GC, 7.9% for pharyngeal GC, 10.2% for rectal GC, 8.4% for urogenital CT, 2.9% for pharyngeal CT, and 14.1% for rectal CT. More than 70% of extragenital GC infections and 85% of extragenital CT infections were associated with negative urethral tests at the same visit and would not have been detected with urethral screening alone. Extragenital GC/CT was common among MSM attending STD clinics, but many MSM were not tested. Most extragenital infections would not have been identified, and likely would have remained untreated, with urethral screening alone. Efforts are needed to facilitate implementation of extragenital GC/CT screening recommendations for MSM.

Study of surveillance data for class B notifiable disease in China from 2005 to 2014.

PubMed

Zhang, Xingyu; Hou, Fengsu; Li, Xiaosong; Zhou, Lijun; Liu, Yuanyuan; Zhang, Tao

2016-07-01

The surveillance of infection is very important for public health management and disease control. It has been 10 years since China implemented its new web-based infection surveillance system, which covers the largest population in the world. In this study, time series data were collected for 28 infectious diseases reported from 2005 to 2014 . Seasonality and long-term trends were explored using decomposition methods. Seasonality was expressed by calculating the seasonal indices. Long-term trends in the diseases were assessed using a linear regression model on the deseasonalized series. During the 10-year period, 38 982 567 cases and 126 372 deaths were reported in the system. The proportion of deaths caused by AIDS increased from 12% in 2005 to 78% in 2014. There were six diseases for which the seasonal index range was greater than 2: dengue fever, Japanese encephalitis, leptospirosis, anthrax, cerebrospinal meningitis, and measles . Among the 28 diseases, the incidence of syphilis increased fastest, with an average increase of 0.018626/100 000 every month after adjustment for seasonality. Effective surveillance is helpful in gaining a better understanding of the infection behaviour of infectious diseases; this will greatly facilitate disease control and management. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Cost-effectiveness of post-landing latent tuberculosis infection control strategies in new migrants to Canada.

PubMed

Campbell, Jonathon R; Johnston, James C; Sadatsafavi, Mohsen; Cook, Victoria J; Elwood, R Kevin; Marra, Fawziah

2017-01-01

The majority of tuberculosis in migrants to Canada occurs due to reactivation of latent TB infection. Risk of tuberculosis in those with latent tuberculosis infection can be significantly reduced with treatment. Presently, only 2.4% of new migrants are flagged for post-landing surveillance, which may include latent tuberculosis infection screening; no other migrants receive routine latent tuberculosis infection screening. To aid in reducing the tuberculosis burden in new migrants to Canada, we determined the cost-effectiveness of using different latent tuberculosis infection interventions in migrants under post-arrival surveillance and in all new migrants. A discrete event simulation model was developed that focused on a Canadian permanent resident cohort after arrival in Canada, utilizing a ten-year time horizon, healthcare system perspective, and 1.5% discount rate. Latent tuberculosis infection interventions were evaluated in the population under surveillance (N = 6100) and the total cohort (N = 260,600). In all evaluations, six different screening and treatment combinations were compared to the base case of tuberculin skin test screening followed by isoniazid treatment only in the population under surveillance. Quality adjusted life years, incident tuberculosis cases, and costs were recorded for each intervention and incremental cost-effectiveness ratios were calculated in relation to the base case. In the population under surveillance (N = 6100), using an interferon-gamma release assay followed by rifampin was dominant compared to the base case, preventing 4.90 cases of tuberculosis, a 4.9% reduction, adding 4.0 quality adjusted life years, and saving $353,013 over the ensuing ten-years. Latent tuberculosis infection screening in the total population (N = 260,600) was not cost-effective when compared to the base case, however could potentially prevent 21.8% of incident tuberculosis cases. Screening new migrants under surveillance with an interferon

Epidemiology of arboviral infections.

PubMed

Ansari, M Z; Shope, R E

1994-01-01

To review the current state of knowledge regarding the epidemiology of arboviruses. Computerized literature searches, identification of papers through review of article bibliographies, and Yale Arbovirus Research Unit, USA. Articles documenting research pertaining to the epidemiology of arboviruses with emphasis on factors that increase or decrease the spread of these infections. The review articles were extracted independently by the authors. Arboviral infections are a global health problem accounting for significant morbidity and mortality in human and animal populations. They belong to the families Togaviridae, Flaviviridae, Bunyaviridae, Reoviridae, and Rhabdoviridae, and are transmitted to humans and domestic animals by the bite of infected arthropods. Rodents and birds are significant vertebrate hosts, while humans are usually not involved in the maintenance and spread of most arboviruses. Ecologic changes and human behavior are important in the spread of these infections. Clinical features range from mild fevers to fatal encephalitis. Surveillance, immunization, and vector control are important methods of prevention. It appears that the distribution and spread of arboviruses is greatly influenced by human behavior and ecologic changes in the environment. Awareness regarding these and other factors, such as travel history, history of bites of arthropods, concurrent epidemic pattern in the community, and knowledge of surveillance data are useful ways of identifying these infections. Future research may be directed toward methodical search for new arboviruses and their relation to human and animal disease.

Food and waterborne infections associated with package holidays.

PubMed

Cartwright, R Y

2003-01-01

The surveillance and prevention of food and waterborne infections in package holiday tourists relies more on common sense and experience rather than evidence based scientific facts. In spite of the major economic value to both sending and receiving countries it is a problem that is largely ignored by health departments at both local and national levels. Package holiday tourism is a growing industry with over 20 million holidays sold every year in the UK. Destinations are in every continent including countries with poorly developed, as well as those with an advanced, public health infrastructure. The incidence of gastrointestinal infection is not reflected in official surveillance programmes as they largely fail to capture information on travel associated infections. Outbreaks of food and waterborne infections in these resorts are largely not investigated. Major British tour operators have responded by developing a crude but effective continuous surveillance system for subjective travellers' diarrhoea. The importance of food and water hygiene is, however, not ignored and proactive preventative programmes are being developed and implemented in some resort as well as by the tourist industry and international agencies. There is a need for further cooperation and partnership between workers in different countries, different disciplines and between the public and private sectors.

Salmonella enteritidis surveillance by egg immunology: impact of the sampling scheme on the release of contaminated table eggs.

PubMed

Klinkenberg, Don; Thomas, Ekelijn; Artavia, Francisco F Calvo; Bouma, Annemarie

2011-08-01

Design of surveillance programs to detect infections could benefit from more insight into sampling schemes. We address the effect of sampling schemes for Salmonella Enteritidis surveillance in laying hens. Based on experimental estimates for the transmission rate in flocks, and the characteristics of an egg immunological test, we have simulated outbreaks with various sampling schemes, and with the current boot swab program with a 15-week sampling interval. Declaring a flock infected based on a single positive egg was not possible because test specificity was too low. Thus, a threshold number of positive eggs was defined to declare a flock infected, and, for small sample sizes, eggs from previous samplings had to be included in a cumulative sample to guarantee a minimum flock level specificity. Effectiveness of surveillance was measured by the proportion of outbreaks detected, and by the number of contaminated table eggs brought on the market. The boot swab program detected 90% of the outbreaks, with 75% fewer contaminated eggs compared to no surveillance, whereas the baseline egg program (30 eggs each 15 weeks) detected 86%, with 73% fewer contaminated eggs. We conclude that a larger sample size results in more detected outbreaks, whereas a smaller sampling interval decreases the number of contaminated eggs. Decreasing sample size and interval simultaneously reduces the number of contaminated eggs, but not indefinitely: the advantage of more frequent sampling is counterbalanced by the cumulative sample including less recently laid eggs. Apparently, optimizing surveillance has its limits when test specificity is taken into account. © 2011 Society for Risk Analysis.

West Nile virus epizootics in the Camargue (France) in 2015 and reinforcement of surveillance and control networks.

PubMed

Bahuon, C; Marcillaud-Pitel, C; Bournez, L; Leblond, A; Beck, C; Hars, J; Leparc-Goffart, I; L'Ambert, G; Paty, M-C; Cavalerie, L; Daix, C; Tritz, P; Durand, B; Zientara, S; Lecollinet, S

2016-12-01

West Nile virus (WNV) infection is a non-contagious disease mainly transmitted by the bites of infected mosquitoes from the genus Culex. The virus is maintained in a mosquito-bird-mosquito cycle, and can accidentally be transmitted to mammalian hosts. Among mammalian hosts, equines and humans are the most sensitive to WNV infection and can develop severe meningoencephalitis. As WNV infections are zoonotic and can be severe in humans and equines, West Nile fever is considered to be a public and animal health concern. After a silent period of almost ten years, WNV re-emerged in France at the periphery of the Camargue area during the summer of 2015, underlining the fact that the Camargue area creates favourable conditions for WNV emergence and amplification in France. The French Network for Epidemiological Surveillance of Equine Diseases (Réseau d'Épidémio-Surveillance en Pathologie Équine [RESPE]) facilitated the early detection of WNV cases in horses. In total, 49 horses were found to be infected; among them, 44 presented clinical signs, 41 with meningoencephalitis and three with hyperthermia only. Six horses among the 41 with nervous symptoms died from the disease or were euthanised (a case fatality rate of 14.6%). The authors describe the characteristics of the 2015 WNV epizootics, the early detection of the first WNV equine cases via the RESPE network and the coordination of WNV surveillance in France. © OIE (World Organisation for Animal Health), 2016.

Using auxiliary information to improve wildlife disease surveillance when infected animals are not detected: a Bayesian approach

USGS Publications Warehouse

Heisey, Dennis M.; Jennelle, Christopher S.; Russell, Robin E.; Walsh, Daniel P.

2014-01-01

There are numerous situations in which it is important to determine whether a particular disease of interest is present in a free-ranging wildlife population. However adequate disease surveillance can be labor-intensive and expensive and thus there is substantial motivation to conduct it as efficiently as possible. Surveillance is often based on the assumption of a simple random sample, but this can almost always be improved upon if there is auxiliary information available about disease risk factors. We present a Bayesian approach to disease surveillance when auxiliary risk information is available which will usually allow for substantial improvements over simple random sampling. Others have employed risk weights in surveillance, but this can result in overly optimistic statements regarding freedom from disease due to not accounting for the uncertainty in the auxiliary information; our approach remedies this. We compare our Bayesian approach to a published example of risk weights applied to chronic wasting disease in deer in Colorado, and we also present calculations to examine when uncertainty in the auxiliary information has a serious impact on the risk weights approach. Our approach allows “apples-to-apples” comparisons of surveillance efficiencies between units where heterogeneous samples were collected

Screening test recommendations for methicillin-resistant Staphylococcus aureus surveillance practices: A cost-minimization analysis.

PubMed

Whittington, Melanie D; Curtis, Donna J; Atherly, Adam J; Bradley, Cathy J; Lindrooth, Richard C; Campbell, Jonathan D

2017-07-01

To mitigate methicillin-resistant Staphylococcus aureus (MRSA) infections, intensive care units (ICUs) conduct surveillance through screening patients upon admission followed by adhering to isolation precautions. Two surveillance approaches commonly implemented are universal preemptive isolation and targeted isolation of only MRSA-positive patients. Decision analysis was used to calculate the total cost of universal preemptive isolation and targeted isolation. The screening test used as part of the surveillance practice was varied to identify which screening test minimized inappropriate and total costs. A probabilistic sensitivity analysis was conducted to evaluate the range of total costs resulting from variation in inputs. The total cost of the universal preemptive isolation surveillance practice was minimized when a polymerase chain reaction screening test was used ($82.51 per patient). Costs were $207.60 more per patient when a conventional culture was used due to the longer turnaround time and thus higher isolation costs. The total cost of the targeted isolation surveillance practice was minimized when chromogenic agar 24-hour testing was used ($8.54 per patient). Costs were $22.41 more per patient when polymerase chain reaction was used. For ICUs that preemptively isolate all patients, the use of a polymerase chain reaction screening test is recommended because it can minimize total costs by reducing inappropriate isolation costs. For ICUs that only isolate MRSA-positive patients, the use of chromogenic agar 24-hour testing is recommended to minimize total costs. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Outcomes of renal transplant recipients with BK virus infection and BK virus surveillance in the Auckland region from 2006 to 2012.

PubMed

Hsiao, Chun-Yuan; Pilmore, Helen L; Zhou, Lifeng; de Zoysa, Janak R

2016-11-06

To evaluate incidence, risk factors and treatment outcome of BK polyomavirus nephropathy (BKVN) in a cohort of renal transplant recipients in the Auckland region without a formal BK polyomavirus (BKV) surveillance programme. A cohort of 226 patients who received their renal transplants from 2006 to 2012 was retrospectively reviewed. Seventy-six recipients (33.6%) had a BK viral load (BKVL) test and 9 patients (3.9%) developed BKVN. Cold ischaemia time (HR = 1.18, 95%CI: 1.04-1.35) was found to be a risk factor for BKVN. Four recipients with BKVN had complete resolution of their BKV infection; 1 recipient had BKVL less than 625 copies/mL; 3 recipients had BKVL more than 1000 copies/mL and 1 had graft failure from BKVN. BKVN has a negative impact on graft function [median estimated glomerular filtration rate (eGFR) 22.5 (IQR 18.5-53.0) mL/min per 1.73 m 2 , P = 0.015), but no statistically significant difference ( P = 0.374) in renal allograft function was found among negative BK viraemia group [median eGFR 60.0 (IQR 48.5-74.2) mL/min per 1.73 m 2 ), positive BK viraemia without BKVN group [median eGFR 55.0 (IQR 47.0-76.0) mL/min per 1.73 m 2 ] and unknown BKV status group [median eGFR 54.0 (IQR 43.8-71.0) mL/min per 1.73 m 2 ]. The incidence and treatment outcomes of BKVN were similar to some centres with BKV surveillance programmes. Recipients with BVKN have poorer graft function. Although active surveillance for BKV has been shown to be effective in reducing incidence of BKVN, it should be tailored specifically to that transplant centre based on its epidemiology and outcomes of BKVN, particularly in centres with limited resources.

Acceptance of the Use of HIV Surveillance Data for Care Engagement: National and Local Community Perspectives

PubMed Central

Evans, David; Van Gorder, Dana; Morin, Stephen F.; Steward, Wayne T.; Gaffney, Stuart; Charlebois, Edwin D.

2015-01-01

Background Use of surveillance data including laboratory results (e.g. CD4 and HIV RNA) by public health departments to facilitate linkage, retention, and re-engagement of HIV-infected individuals in health care is on the rise. This is part of the goal of increasing the proportion of infected persons achieving virologic suppression. However, this use of surveillance data is not without controversy, particularly among some providers and people living with HIV. Methods We conducted informal discussions with key stakeholders and a literature search, and held a national think tank in November 2012, bringing together 31 representatives of the federal government, county and state officials, health care providers, and community-based organizations. A follow-up community consultation specific to San Francisco was held January 24, 2014, with 10 participants. Notes from these activities were used as data for this analysis. Results The think tank identified three strategies utilizing HIV surveillance data to aid in care engagement: 1) provider-mediated – where health department staff work with the provider of record on re-engagement, 2) electronic linkages between surveillance databases and medical records databases, and 3) direct outreach – where trained health department staff reach out to persons out of care. Participants also developed recommendations for minimizing harm, guidance on meaningful stakeholder involvement, and a consensus statement in support of the use of HIV surveillance data in care engagement. Conclusions Acceptance of the use of surveillance data for HIV care linkage, retention, and re-engagement is achievable, particularly if stakeholders have been engaged in the design, conduct, and evaluation of programs. PMID:25867776

Multistate Point-Prevalence Survey of Health Care–Associated Infections

PubMed Central

Magill, Shelley S.; Edwards, Jonathan R.; Bamberg, Wendy; Beldavs, Zintars G.; Dumyati, Ghinwa; Kainer, Marion A.; Lynfield, Ruth; Maloney, Meghan; McAllister-Hollod, Laura; Nadle, Joelle; Ray, Susan M.; Thompson, Deborah L.; Wilson, Lucy E.; Fridkin, Scott K.

2015-01-01

BACKGROUND Currently, no single U.S. surveillance system can provide estimates of the burden of all types of health care–associated infections across acute care patient populations. We conducted a prevalence survey in 10 geographically diverse states to determine the prevalence of health care–associated infections in acute care hospitals and generate updated estimates of the national burden of such infections. METHODS We defined health care–associated infections with the use of National Healthcare Safety Network criteria. One-day surveys of randomly selected inpatients were performed in participating hospitals. Hospital personnel collected demographic and limited clinical data. Trained data collectors reviewed medical records retrospectively to identify health care–associated infections active at the time of the survey. Survey data and 2010 Nationwide Inpatient Sample data, stratified according to patient age and length of hospital stay, were used to estimate the total numbers of health care–associated infections and of inpatients with such infections in U.S. acute care hospitals in 2011. RESULTS Surveys were conducted in 183 hospitals. Of 11,282 patients, 452 had 1 or more health care–associated infections (4.0%; 95% confidence interval, 3.7 to 4.4). Of 504 such infections, the most common types were pneumonia (21.8%), surgical-site infections (21.8%), and gastrointestinal infections (17.1%). Clostridium difficile was the most commonly reported pathogen (causing 12.1% of health care–associated infections). Device-associated infections (i.e., central-catheter–associated bloodstream infection, catheter-associated urinary tract infection, and ventilator-associated pneumonia), which have traditionally been the focus of programs to prevent health care–associated infections, accounted for 25.6% of such infections. We estimated that there were 648,000 patients with 721,800 health care–associated infections in U.S. acute care hospitals in 2011

Vibrio infections in Louisiana: twenty-five years of surveillance 1980-2005.

PubMed

Thomas, Annu; Straif-Bourgeois, Susanne; Sokol, Theresa M; Ratard, Raoult C

2007-01-01

A total of 1,007 Vibrio infections were reported to the Infectious Disease Epidemiology Department at the Louisiana Office of Public Heath, between 1980 and 2005. The most common were Vibrio vulnificus (257 infections), Vibrio parahemolyticus (249 infections), and Vibrio cholerae non O1 (200 cases). Other species were much less common. Vibrio vulnificus infections, which are associated with consumption of raw seafood (particularly oysters) or contact with sea water, and severe immuno-suppression or liver disease were increasing. Septicemia and blood stream infections are the main manifestations of this infection. The number of infections due to Vibrio parahemolyticus on the other hand, causing mostly gastroenteritis, has remained stable. Vibrio cholerae infections are less common and almost always associated with consumption of partially cooked or contaminated crabs.

Development of integrated surveillance systems for the management of tuberculosis in New Zealand wildlife.

PubMed

Anderson, D P; Ramsey, D S L; de Lisle, G W; Bosson, M; Cross, M L; Nugent, G

2015-06-01

Disease surveillance for the management of bovine tuberculosis (TB) in New Zealand has focussed, to a large extent, on the development of tools specific for monitoring Mycobacterium bovis infection in wildlife. Diagnostic techniques have been modified progressively over 30 years of surveillance of TB in wildlife, from initial characterisation of gross TB lesions in a variety of wildlife, through development of sensitive culture techniques to identify viable mycobacteria, to molecular identification of individual M. bovis strains. Of key importance in disease surveillance has been the elucidation of the roles that different wildlife species play in the transmission of infection, specifically defining brushtail possums (Trichosurus vulpecula) as true maintenance hosts compared to those that are predominantly spillover hosts, but which may serve as useful sentinel species to indicate TB persistence. Epidemiological modelling has played a major role in TB surveillance, initially providing the theoretical support for large-scale possum population control and setting targets at which control effort should be deployed to ensure disease eradication. As TB prevalence in livestock and wildlife declined throughout the 2000s, more varied field tools were developed to gather surveillance data from the diminishing possum populations, and to provide information on changing TB prevalence. Accordingly, ever more precise (but disparate) surveillance information began to be integrated into multi-faceted decision-assist models to support TB management decisions, particularly to provide informed parameters at which control effort could be halted, culminating in the Proof of Freedom modelling framework that now allows an area to be declared TB-free within chosen confidence limits. As New Zealand moves from large-scale TB control to regional eradication of disease in the coming years, further integrative models will need to be developed to support management decisions, based on combined

Detecting borderline infection in an automated monitoring system for healthcare-associated infection using fuzzy logic.

PubMed

de Bruin, Jeroen S; Adlassnig, Klaus-Peter; Blacky, Alexander; Koller, Walter

2016-05-01

Many electronic infection detection systems employ dichotomous classification methods, classifying patient data as pathological or normal with respect to one or several types of infection. An electronic monitoring and surveillance system for healthcare-associated infections (HAIs) known as Moni-ICU is being operated at the intensive care units (ICUs) of the Vienna General Hospital (VGH) in Austria. Instead of classifying patient data as pathological or normal, Moni-ICU introduces a third borderline class. Patient data classified as borderline with respect to an infection-related clinical concept or HAI surveillance definition signify that the data nearly or partly fulfill the definition for the respective concept or HAI, and are therefore neither fully pathological nor fully normal. Using fuzzy sets and propositional fuzzy rules, we calculated how frequently patient data are classified as normal, borderline, or pathological with respect to infection-related clinical concepts and HAI definitions. In dichotomous classification methods, borderline classification results would be confounded by normal. Therefore, we also assessed whether the constructed fuzzy sets and rules employed by Moni-ICU classified patient data too often or too infrequently as borderline instead of normal. Electronic surveillance data were collected from adult patients (aged 18 years or older) at ten ICUs of the VGH. All adult patients admitted to these ICUs over a two-year period were reviewed. In all 5099 patient stays (4120 patients) comprising 49,394 patient days were evaluated. For classification, a part of Moni-ICU's knowledge base comprising fuzzy sets and rules for ten infection-related clinical concepts and four top-level HAI definitions was employed. Fuzzy sets were used for the classification of concepts directly related to patient data; fuzzy rules were employed for the classification of more abstract clinical concepts, and for top-level HAI surveillance definitions. Data for each